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Texas Employer New Hire Reporting Form
Submit within 20 calendar days of new employee’s
first day of work to: To ensure the highest level of accuracy, please print neatly
ENHR Operations Center, P.O. Box 149224 in capital letters and avoid contact with the edges of the
Austin, TX 78714-9224 boxes. The following will serve as an example:
Phone: 1-800-850-6442 FAX: 1-800-732-5015
Online: www.employer.texasattorneygeneral.gov A B C 1 2 3

Employer Information
1. Federal Employer ID Number (FEIN): 2. State Employer ID Number (Optional):
Please use the same FEIN that appears on quarterly wage reports.

3. Employer Name:

4. Employer Address (Please indicate the address where the Income Withholding Orders should be sent):

5. Employer City (if US): 6. State (if US): 7. ZIP Code (if US):
_

8. Province/Region (if foreign): 9. Country (if foreign): 10. Postal Code (if foreign):

11. Employer Telephone (Optional): 12. Employer FAX (Optional):

13. New Hire Contact Person (Optional):

Employee Information
14. Social Security Number (SSN): 15. Date of Hire (MM/DD/YYYY):

16. Employee First Name:

17. Employee Middle Name:

18. Employee Last Name:

19. Employee Home Address:

20. Employee City (if US): 21. State (if US): 22. ZIP Code (if US):
_

23. Province/Region (if foreign): 24. Country (if foreign): 25. Postal Code (if foreign):

26. State Where Employee Was Hired (Optional): 27. Employee DOB (MM/DD/YYYY) (Optional):

28. Employee’s Salary (Dollars and Cents) (Optional):

29. Salary Frequency (Check One ONLY) (Optional):
Hourly Weekly Biweekly Semi-Monthly Monthly Annually

REV 12/13 ENHR RPT FORM

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INSTRUCTIONS FOR COMPLETING THE TEXAS EMPLOYER NEW HIRE REPORTING FORM
The purpose of the Texas New Hire Reporting Form is to allow employers to fulfill new hire reporting requirements. You may enter your
employer information and photocopy a supply and then enter employee information on the copies.

REPORTING OF NEW HIRES IS REQUIRED:
All required items (numbers 1, 3, 4, 5, 6, 7, 14, 15, 16, 17, 18, 19, 20, 21, 22) on this form must be completed.

Box 1: Federal Employer ID Number (FEIN). Provide the 9-digit employer identification number that the federal government assigns to the
employer. This is the same number used for federal tax reporting. Please use the same FEIN that appears on quarterly wage reports.

Box 2: State Employer ID Number (Optional). Identification number assigned to the employer by the Texas Workforce Commission.

Box 3: Employer Name. The employer name as listed on the employee’s W4 form. Please do not provide more than one employer name
(for example, “ABC, Inc DBA. John Doe Paint and Body Shop” is not correct).

Box 4: Employer Address. Please indicate the address where the Income Withholding Orders should be sent. Do not provide more
than one address (for example, P.O. Box 123, 1313 Mockingbird Lane is not correct).

Box 8: Employer Province/Region (if foreign). Provide this information if the employer address is not in the United States.

Box 9: Employer Country (if foreign). Provide the two letter country abbreviation if the employer address is not in the United States.

Box 10: Postal Code (if foreign). Provide the postal code if the employer address is not in the United States.

Box 13: New Hire Contact Person (Optional). Providing the name of a contact staff person will facilitate communication between the
employer and the Texas Employer New Hire Reporting Program.

Box 15: Date of Hire. List the date in month, day and year order. Use four digits for the year (for example, 2001). This should be the first
day that services are performed for wages by an individual. If you are reporting a rehire (where a new W-4 is prepared) use the return date,
not the original date of hire.

Box 23: Employee Province/Region (if foreign). Provide this information if the employee does not reside in the United States.

Box 24: Employee Country (if foreign). Provide the two letter country abbreviation if the employee address is not in the United States.

Box 25: Postal Code (if foreign). Provide the postal code if the employee address is not in the United States.

Box 26: State Where Employee was Hired. Use the abbreviation recognized by the U.S. Postal Service for the state in which the
employee was hired.

Box 27: Employee DOB (Date of Birth) (Optional). List the date in month, day and year order. Use four digits for the year (for example,
1985).

Box 28: Employee Salary (Optional). Enter employee’s exact wages in dollars and cents. This should correspond to the salary pay
frequency indicated in Box 29.

Box 29: Salary (Check One ONLY) (Optional). Check the appropriate box relating to the employee’s salary pay frequency. Check “ Bi-
weekly” if the salary is based on 26 pay periods. Check “Semi-monthly” if the salary is based on 24 pay periods. Check “Annually” if salary
payment is a one-time distribution.

SUBMISSION OF NEW HIRE REPORTS. The Texas Employer New Hire Reporting Program offers a variety of methods that employers
can use to submit new hire reports. For further information on which method may be best for you, call 1-800-850-6442. Employers are
encouraged to keep photocopies or electronic records of all reports submitted. When the form is completed, send it to the Texas Employer
New Hire Reporting Program using one of the following means:

 FAX: 1-800-732-5015
 U.S. Mail:

ENHR Operations Center
P.O. Box 149224
Austin, TX 78714-9224

 Telephone Submissions: 1-800-850-6442
 Internet Submissions: www.employer.texasattorneygeneral.gov

Employers must provide all of the required information within 20 calendar days of the employee's first day of work to be in
compliance. State law provides a penalty of $25 for each employee an employer knowingly fails to report, and a penalty of $500 for
conspiring with an employee to 1) fail to file a report or 2) submit a false or incomplete report.

REV 12/13 ENHR RPT FORM

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