Fillable NE Form Virginia New Hire Reporting Center

Fill Online, Printable, Fillable, Blank NE Form Virginia New Hire Reporting Center Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

NE Form Virginia New Hire Reporting Center

On average this form takes 7 minutes to complete

The NE Form Virginia New Hire Reporting Center form is 1 page long and contains:

  • 0 signatures
  • 1 check-box
  • 28 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Send completed forms to:
Nebraska State Directory of New Hires
P.O. Box 144013
Austin, TX 78714-4013
Fax: (866) 808-2007 (toll-free)
EMPLOYER INFORMATION
Employer Name:
Employer Address (Please indicate the address where the Income Withholding Orders should be sent):
Federal Employer ID Number (FEIN)(Please use the same FEIN as the listed employee’s quarterly wages will be reported under):
Employer City:
Employer State:
Zip Code (5 digit):
Employee Social Security Number (SSN):
Employee First Name:
Middle Initial
Employee Last Name:
Employee Address:
Employee City:
Employee State:
Zip Code (5 digit):
Date of Hire (mm/dd/yyyy):
Check this box if this is an
independent Contractor (1099)
Date of Birth (mm/dd/yyyy):
Employee State of Hire:
E-mail:
To ensure the highest level of accuracy, please print neatly in capital
letters and avoid contact with the edges of the boxes. Example:
A
B
C
1
2
3
Rev (09/16)
Dependent health insurance available?
Yes
No
Date employee qualifies for family health insurance (mm/dd/yyyy):
Employer Phone:
Employer Fax:
Extension:
Nebraska New Hire Reporting Form
Effective October 1, 1997, Nebraska Statute 48-2301 requires all Nebraska Employers, both public and private, to report
all newly hired, rehired or returning to work employees to the State of Nebraska within 20 days of hire or rehire date.
Questions? www.ne-newhire.com Toll-free: (888) 256-0293
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

NE Form Virginia New Hire Reporting Center

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 25 August 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document