Form Nhes 0085 - Nhes New Hire Reporting Form

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F
I
N
: ______________________________
EDERAL
DENTIFICATION
O
NHES E
A
N
: ___________________________
MPLOYER
CCOUNT
O
NEW HIRE REPORTING FORM
R
T
: NHES -N
H
P
E
N
: _______________________________________
ETURN
O
EW
IRE
ROGRAM
MPLOYER
AME
PO B
2092
OX
C
NH 03302-2092
E
A
: ____________________________________
ONCORD
MPLOYER
DDRESS
F
: (603) 224-0825
AX
T
F
F
: 1-855-253-9072
_____________________________________________________
OLL
REE
AX
E
T
N
: (
) _________________________
MPLOYER
ELEPHONE
O
Note:
E
For “Type of Hire” write “W” for W-2
MPLOYEE
E
F
N
: (
) _______________________________
MPLOYER
AX
O
I
C
or “I” for 1099
NDEPENDENT
ONTRACTOR
E
C
P
: _____________________________
MPLOYER
ONTACT
ERSON
S
S
N
E
N
A
C
/T
S
Z
D
W
T
OCIAL
ECURITY
O
MPLOYEE
AME
DDRESS
ITY
OWN
TATE
IP
ATE
ORK
YPE OF
S
H
OF
TATE
IRE
(NOT PO BOX)
H
IRE
W
I
OR
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-
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Note: All new hires must be reported within 20 days of the date hired.
NHES 0085
The date of hire is the first day the individual performs services for you
R-10/13
Online “New Hire” filing link can be found on homepage

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