for
05601-0488 Working
Date Employee Actually Began Compensation C-61 WEB (04/13)

Return to: to: 802-828-4286
P.O. Box 488
ATTN: New Hire
NEW HIRE REPORTING FORM FAX 
Vermont Department of Labor Montpelier, VT or

first day work is performed for compensation. 

Address (Street, City/Town, State, Zip Code)

   Employee Name

All new hires must be reported within 10 days of the date of hire, the 

the following address: http://www.labor.vermont.gov NOTE: All rehires must be reported if they were previously employed by the employer but have been separated from such  employment for at least 60 consecutive days.

This information may also be submitted through the internet at 

Federal Identification No.: Employer Name: Employer Address: 

Social Security No.