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Get Ohio New Hire Reporting Form 2013-2024

Ohio Department of Job and Family Services OHIO NEW HIRE REPORTING Ohio Revised Code section 3121. 89 to 3121. 8910 requires all Ohio employers both public and private to report all contractors and newly hired employees to the state of Ohio within 20 days of the contract or hire date. Information about new hire reporting and online reporting is available on our website www. oh-newhire. The following will serve as an example Send completed forms to Ohio New Hire Reporting Center PO Box 15309 Columbus OH 43215-0309 Fax 614 221-7088 or toll-free fax 888 872-1611 A B C EMPLOYER INFORMATION Federal Employer ID Number FEIN Please use the same FEIN as the listed employee s quarterly wages will be reported under Employer Name Employer Address Please indicate the address where the Income Withholding Orders should be sent. 8910 requires all Ohio employers both public and private to report all contractors and newly hired employees to the state of Ohio within 20 days of the contract or hire date. Information about new hire reporting and online reporting is available on our website www. oh-newhire. com To ensure the highest level of accuracy please print neatly in capital letters and avoid contact with the edges of the boxes. Employer City Employer State Employer Phone optional Zip Code 5 digit Employer Fax optional Extension Email EMPLOYEE OR CONTRACTOR INFORMATION Check here if using FEIN for the Contractor Social Security Number SSN State of Hire First Name Middle Initial Last Name Address City State Date of Birth Is this a Contractor Yes Date payments will begin for Contractor No Length of time the Contractor will be performing services months REPORTS WILL NOT BE PROCESSED IF REQUIRED INFORMATION IS MISSING Questions Call us at 614 221-5330 or toll-free 888 872-1490 JFS 07048 Rev* 12/2013. Information about new hire reporting and online reporting is available on our website www. oh-newhire. com To ensure the highest level of accuracy please print neatly in capital letters and avoid contact with the edges of the boxes. .

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