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                 NEW  MEXICO     NEW     HIRE        Mail Reports to:   
                                                     New Mexico New Hire  Directory    
                 REPORTING FORM                      PO     Box 2999     
                                                     Mercerville, NJ 08690   
                                        
                                                     Fax Reports to:  888-878-1614  
                                    
                          EMPLOYER    INFORMATION 

                          EMPLOYEEE    INFORMATION 
                                                                                              
  Toll     (888) 878-1607   www.NM-newhire.com        Toll Free Fax: (888) 878-1614 
   Free Phone:                                                                       
                                                                                             
                                                                               Rev. 06/19 






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