Idaho Department of Labor 
Unemployment Insurance Compliance Bureau 
New Hire Reporting | Phone: (208) 332-8741 
Web: labor.idaho.gov 

                                  NEW HIRE  EPORTING R      ORMF

This form must be completed, signed, and returned to the Idaho Department of Labor within 20 days of 
your new employee’s start date. You must report employees that you re-hire unless it has been less than 
60 days since their last period of employment.  

You  may  return  the  form  via  Employer  Portal  secure  messaging,  fax  to 208-332-7411, or  mail  to 
Idaho  Department  of  Labor,  ATTN  New  Hire  Reporting,  317  W.  Main  St.,  Boise, Idaho 
83735-0760. 

                                   Employer Information 
Unemployment Insurance Tax Account Number (EAN):  
Federal Employer Identification Number (FEIN):  
Legal Business Name:  
DBA:  
Mailing Address:  
City, State, Zip:  

                                   Employee Information 
First Name                         M.I.     Last Name                        Social Security Number 

Physical Address                                                             Start Date or Rehire Start Date1 

City                               State        Zip Code (Zip Ext. Optional) 

First Name                         M.I.     Last Name                        Social Security Number 

Physical Address                                                             Start Date or Rehire Start Date1 

City                               State        Zip Code (Zip Ext. Optional) 

First Name                         M.I.     Last Name                        Social Security Number 

Physical Address                                                             Start Date or Rehire Start Date1 

City                               State        Zip Code (Zip Ext. Optional) 

                                                                    EAN:   
                                                                    FEIN:   
 
 First Name                     M.I.  Last Name                     Social Security Number 
                                 
 Physical Address                                                   Start Date or Rehire Start Date1 
  
 City                           State  Zip Code (Zip Ext. Optional)  
  
 First Name                     M.I.  Last Name                     Social Security Number 
                                 
 Physical Address                                                   Start Date or Rehire Start Date1 
  
 City                           State  Zip Code (Zip Ext. Optional)  
  
 First Name                     M.I.  Last Name                     Social Security Number 
                                 
 Physical Address                                                   Start Date or Rehire Start Date1 
  
 City                           State  Zip Code (Zip Ext. Optional)  
  
 First Name                     M.I.  Last Name                     Social Security Number 
                                 
 Physical Address                                                   Start Date or Rehire Start Date1 
  
 City                           State  Zip Code (Zip Ext. Optional)  
  
 First Name                     M.I.  Last Name                     Social Security Number 
                                 
 Physical Address                                                   Start Date or Rehire Start Date1 
  
 City                           State  Zip Code (Zip Ext. Optional)  
  
1Start Date or Rehire Start Date means the actual commencement of employment of an employee for wages or other remuneration as defined 
in Idaho Code §72-1603. 
 
I, _______________________________, am requesting the employees listed above be reported as new 
hires under the EAN provided. By signing this document, you agree you are authorized to submit this 
request.  
 
______________________    ________________  _____________   ___________________________ 
Name                     Phone         Date          Signature