Arizona New Hire Reporting Form at a glance
What it is: Arizona New Hire Reporting Form: complete one entry for each new employee.
Where and when to file: Mail completed form to: Arizona New Hire Reporting Center P.O Box 402 Holbrook, MA 02343. Or fax completed form to: 1-888-282-0502 toll-free fax.
A filled-in Arizona New Hire Reporting Form example: an employer reports one new employee
How to fill out Arizona New Hire Reporting Form, box by box
Employer information
Enter the Federal Employer Identification Number (FEIN); use the same FEIN for which listed employee(s) quarterly wages will be reported under.
Enter the Employer Name and the DBA.
Enter the Contact Name, Telephone and Email.
Enter the Address where the Income Withholding Order will be sent, with the City, State, Zip Code and +4.
Employee information
Under EMPLOYEE INFORMATION, enter the Social Security Number.
Enter the Employee First Name, Middle and Employee Last Name.
Enter the Employee Address, with the City, State, Zip Code and +4.
* OPTIONAL: Date of Birth and Date of Hire are marked *.
Employee benefit
Is medical insurance an employee benefit? and Is this employee eligible for an insurance benefit? are marked *: * OPTIONAL.
More rules for Arizona New Hire Reporting Form
For information please visit www.az-newhire.com or call toll-free at 1-888-282-2064; the Arizona New Hire Reporting Center is an authorized agent of the Arizona Department of Economic Security.
Common questions about Arizona New Hire Reporting Form
Where do I file it?
Mail completed form to: Arizona New Hire Reporting Center P.O Box 402 Holbrook, MA 02343.
Sources
[1] Arizona New Hire Reporting Form (Rev 03/2010), Arizona New Hire Reporting Center (the Official source link on this page).
