Michigan Department of Treasury
Michigan New Hire
3281(Rev. 9-12)
Operations Center
P.O. Box 85010
State of Michigan New Hire Reporting Form
Lansing, MI 48908-5010
Federal law requires public (State and local) and private employers to report all newly hired or rehired employees who are working
Phone: (800) 524-9846
in Michigan to the State of Michigan.
1
This form is recommended for use by all employers who do not report electronically.
Fax: (877) 318-1659

A newly hired employee is an individual not previously employed by you, and
a rehired employee is an individual who was previously employed by you but
separated from employment for at least 60 consecutive days.

Reports must be submitted within 20 days of hire date (i.e., the date services
are rst performed for pay).

This form may be photocopied as necessary. Many employers preprint employer
information on the form and have the employee complete the necessary
information during the hiring process.

When reporting new hires with special exemptions, please use the MI-W4 form.

Online and other electronic reporting options are available at:
www.mi-newhire.com
.

Employers who report electronically and have employees working in two or
more states may register as a multi-state employer and designate a single state
to which new hire reports will be transmitted. Information regarding multi-state
registration is available online at: http://www.acf.hhs.gov/programs/cse/
newhire/employer/private/newhire.htm#multi or call
(410) 277-9470.
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Reports will not be processed if mandatory information is missing. Such reports
willl be rejected and you must correct and resubmit them.
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For optimum accuracy, please print neatly in all capital letters and avoid contact
with the edge of the box. See sample below.
A B C 1 2 3
OPTIONAL
First Name:
Last Name:
Address:
City:
Zip Code:
Date of Birth:
EMPLOYEE Information (Mandatory)
Driver’s License No:
Social Security Number:
Middle Initial:
State:
Hire Date:
OPTIONAL
Employer Name:
Address:
City:
Zip Code:
Contact Name:
Contact Phone:
Contact Email:
EMPLOYER Information (Mandatory)
Federal Employer Identification Number (FEIN):
State:
Contact Fax:
1
Ref: Social Security Act section 453A and the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 (P.L. 104-193), effective October 1, 1997.
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