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| Question | Answer |
|---|---|
| Form Name | Form Csf 01 0580 |
| Form Length | 3 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 45 sec |
| Other names | Prsnnl New_Hire Rehire_Reporting_Form oregon new hire reporting form |
Oregon New Hire Reporting Form
Please visit us at www.oregonchildsupport.gov/employers for additional information and to download this form.
Mail or Fax completed form to: |
Telephone: |
(503) |
Department of Justice |
Toll Free |
(866) |
Employer New Hire Reporting Program |
Fax: |
(503) |
4600 25th Ave NE Suite 180, Salem, OR 97301 |
Toll Free Fax: |
(877) |
Reports must be submitted no later than 20 days after the hire/rehire date |
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Required Information *
Employer Information |
Please use the same FEIN used to report quarterly wage information |
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* Employer Federal Identification Number (FEIN) |
State Identification Number |
Submission Date |
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* Employer Name |
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DBA (Doing Business As) Name |
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* Employer Street/Mailing Address |
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* Contact Name |
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* Employer City |
* State |
* Zip Code |
* Contact Phone Number |
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Email: |
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* Should the Child Support Program mail income withholding orders to the above address? Yes [ ] No [ ] If No, please provide payroll office address and contact person information below.
Payroll Office Mailing Address |
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Zip Code |
Contact Phone Number/fax number |
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Email: |
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(By reporting health insurance availability information below, your company may avoid receiving unnecessary forms)
*Do any employees and their dependents have access to one or more health care plans through the employer or a union? Yes [ ] No [ ] Union name and phone number:
If yes, is there a waiting period for eligibility? Yes [ ] No [ ] If Yes, how long?
*Employee=s name and SSN must exactly match what is on their SSN card. Please identify first, middle, and last name.
Employee Information
* Social Security Number |
*First Work Date |
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Date of Birth |
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* First Name |
* Middle Name |
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* Last Name |
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* Employee Street/Mailing Address |
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* State |
* Zip Code |
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Employee email address |
Home phone |
Cell phone |
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Page 1 of 3 - OREGON NEW HIRE REPORTING FORM CSF 01 0580 (Rev. 07/20/11)
New Hire Reporting - continued
* Employer Name
* Employer Federal ID Number
*Contact Name
* Contact Phone Number
* Social Security Number |
*First Work Date |
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* Employee Street/Mailing Address |
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* Zip Code |
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* Social Security Number |
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Page 2 of 3 - OREGON NEW HIRE REPORTING FORM CSF 01 0580 (Rev. 07/20/11)
Instructions
How to fill out the New Hire Reporting Form
Employer Info:
Please make sure you use the same Federal Tax ID Number (FEIN) that you use to report your quarterly wage information.
Including a contact person, phone number and email address is optional but extremely helpful, particularly if there is missing required information or the required information is unclear and employer services need to contact the employer.
Different address and contact information for withholding orders?
Please fill out this box if your company has a payroll service or another address where income withholding orders should be sent.
Is health care coverage available?
If your company doesn=t offer dependent or family health care coverage to any of your employees, please mark the
ANo@ box. If your company does offer dependent or family health care coverage to any of your employees, or if your employee is represented by a union and the union offers dependent or family health care coverages to any of your employees, please mark the AYes@ box. If yes is marked, please provide the waiting period, if any, and provide the union=s name, telephone number and the waiting period, if known.
Employee:
Please make sure the employee=s name and the Social Security Number match the employee=s Social Security card, including first, middle and last names.
Dates of birth are optional but very helpful in verification of employment and missing or unclear new hire information.
An employee address should be a valid address as used by the US Postal Service.
Reporting Helpful Hints
Oregon law requires all employers to submit their new hire reports within 20 days after the employee=s hire date. This includes rehires. ARehire@ means to
If you have never reported before, please report only those current employees for whom you have not reported quarterly wage information to the Oregon Employment Department. Do not submit a list of all current employees as this creates unnecessary processing of duplicate information.
We have a variety of methods available for use in reporting:
Electronic filing through FilesDirect.com. This secure website is free and user friendly. Contact employer services at
Complete, print and fax or mail the information on the PDF form found on our website at: www.oregonchildsupport.gov/forms/csf010580.pdf (Our contact information is on the top of the attached form)
Complete the attached form making sure the information is legible. Keep in mind that if the report is faxed, it can distort the information received.
A secure Employer
Due to security concerns, we are not accepting new hire reports via
Page 3 of 3 - OREGON NEW HIRE REPORTING FORM
CSF 01 0580 (Rev. 07/20/11)