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                  South Carolina New Hire Reporting Form 
If you use this form to report newly hired or rehired employees, please make and keep additional copies for 
future reporting. 
 
                       EMPLOYER INFORMATION 
 
 Employer Name 
  
 Employer Address 
  
 City                  State                          Zip 
  
 Federal Employer Identification Number (Fed. Tax ID) Contact Name and Phone Number 
                                                       
                  NEWLY HIRED OR REHIRED EMPLOYEE INFORMATION: 
 
 Employee Name 
  
 Employee Address 
  
 City                  State                              Zip 
  
 SSN                   Date of Birth                      Date of Remuneration (1 stday of work) 
  
 Employee Name 
  
 Employee Address 
  
 City                  State                              Zip 
  
 SSN                   Date of Birth                      Date of Remuneration (1 stday of work) 
  
                       https://newhire.sc.gov 
Mail completed form to: South Carolina Department of Social Services, Child Support Services Division, 
Attn: New Hire Reporting Program, PO Box 1469, Columbia, SC 29202-1469.  
You may fax completed form to: (803) 898-9100.          Phone: (803) 898-9235  






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