JFS 07048 (Rev. 2/2021)
Ohio Department of Job and Family Services
OHIO NEW HIRE REPORTING
Ohio Revised Code sections 3121.89 to 3121.8910 require 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
Send completed forms to:
To ensure the highest level of accuracy, please print neatly
in capital letters and avoid contact with the edges of the
boxes. The following will serve as an example:
Ohio New Hire Reporting Center
P.O. Box 15309
Columbus, OH 43215-0309
Fax: (614) 221-7088 or Toll-Free Fax: (888) 872-1611
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 Order should be sent)
Employer City
Employer State
Employer Zip Code
Employer Phone (Optional)
Extension
Employer Fax (Optional)
Employer E-mail
EMPLOYEE OR CONTRACTOR INFORMATION
Social Security Number (SSN)
- -
(Check here if using FEIN for the Contractor)
First Name
Middle Initial
Last Name
Address
City
State
ZIP Code
Date of Hire
Date of Birth
Is this a Contractor? Yes No
Date payments will begin for Contractor
Length of time the Contractor will be performing services
months
REPORTS WILL NOT BE PROCESSED IF REQUIRED INFORMATION IS MISSING
If you have questions call us at (614) 221-5330 or toll-free (888) 872-1490
3
2
1
C
B
A
