NH-3 
REV. 07-16 

                                                        NEW HIRE REPORTING FORM 

                                                        IDAHO DEPARTMENT OF LABOR 
                                                        NEW HIRE REPORT ING 
                                                        317 W MAIN ST         FAX    1-208-332-7411 
                                                        BOISE, ID  83735-0610       PHONE 1-800-627-3880 
                                                        https://www.labor.idaho.gov/dnn/Businesses/NewHire

EMPLOYER INFORMATION 
Federal Employer Identification Number (FEIN)           Idaho Unemployment Insurance Number (SUTA) 

Name                                                    Contact Phone Number 

Street Address                                          Contact Name 

City                                          State     8 ZIP                       Fax 

EMPLOYEE INFORMATION 
First Name           M.I.                     Last Name                             Social Security Number 

Street Address                                                                      Start Date (mm dd yyyy/ /  ) 

City                                          State     ZIP 

EMPLOYEE INFORMATION 
First Name           M.I.                     Last Name                             Social Security Number 

Street Address                                                                      Start Date (mm dd yyyy/ /  ) 

City                                          State     ZIP 

EMPLOYEE INFORMATION 
First Name           M.I.                     Last Name                             Social Security Number 

Street Address                                                                      Start Date (mm dd yyyy/ /  

City                                          State     ZIP 

EMPLOYEE INFORMATION 
First Name           M.I.                     Last Name                             Social Security Number 

Street Address                                                                      Start Date (mm dd yyyy/ / ) 

City                                          State     ZIP 

EMPLOYEE INFORMATION 
First Name           M.I.                     Last Name                             Social Security Number 

Street Address                                                                      Start Date (mm dd yyyy/ / ) 

City                                          State     ZIP