NEW HIRE REPORTING INFORMATION FOR PENNSYLVANIA

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Thank you for downloading Agent 77 s NEW HIRE REPORTING INFORMATION FOR PENNSYLVANIA. This form is provided to you as is. As provided, we believe it meets all requirements needed for Federal compliance, as applicable, at the time you download it. We offer it to you in a form to which you can easily add your company name and logo if desired. However, any substantive change to the contents of this document may result in potential legal liability for you and your company. Agent 77, Inc. accepts no liability or responsibility for any of our documents that have had the contents altered beyond simply filling in the appropriate blanks and/or replacing place holder text and adding your company logo and information. This document is sold to you with the understanding it is not a legal or accounting opinion and should not be construed as such, and that Agent 77, Inc. is not engaged in the business of rendering legal or accounting services. If you need specific advice on any legal or accounting issue, the services of a competent professional should be sought. Please see www.agent77.com/legal for more information. This and all documents downloaded from our website are Copyright 2004, 2008 Agent 77, Inc. Reminder: The license that you previously agreed to prohibits you from copying and distributing this NEW HIRE REPORTING INFORMATION FOR PENNSYLVANIA to anyone outside of your company. Doing so is a violation of your license and will result in the revocation of your subscription and/or prosecution under Federal copyright laws as well as possible civil litigation. Please see www.agent77.com/legal for a copy of the current license agreement. 01116-44-02T 080108

1. What is the new hire law? The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 was passed as part of the larger welfare reform legislation. This Act requires that all employers report information on people they hire or re-hire to a state directory shortly after they are hired. Although a Federal law, this legislation looks to the individual states to implement the law and to maintain the directories of new hires. Pennsylvania Consolidated Statutes, Title 23, Chapter 43, Sections 4391 through 4396 is the implementation of PRWORA within the State of Pennsylvania. 2. Why is new hire reporting required? New hire reporting was designed to speed up any child support withholding order processes by expediting collection of child support from parents who change jobs frequently. It also helps locate non-custodial parents to help in establishing paternity and child support orders. Thus, employers serve as key partners in ensuring financial stability for many children and families by helping them receive the financial support they deserve. 3. Who is required to report? Employers doing business in the state of Pennsylvania must report on the following employees: New Employees: Employers must report information on newly hired employees who reside or work in the State of Pennsylvania. This includes employees of all ages, those who work less than a full day, those still in a probationary period, part-time and seasonal employees. This information must be reported even if the employee is employed for only one day before termination. Rehired or recalled employees: Employers must report information on employees who are rehired or recalled to work after being laid off, furloughed, separated, granted a leave without pay or are terminated from employment after 30 days and who reside or work in the State of Pennsylvania. Temporary employees: Temporary agencies are responsible for reporting information on any employee hired to report for an assignment. This need be done only once, employees do not need to be re-reported each time they report to a new client, unless there is a break in service or gap in wages, in which case they need to be reported as a rehire. Employers doing business in the state of Pennsylvania must report information on anyone hired if the individual is considered an employee for purposes of paying federal income tax withholding. This includes employees of all ages, those who work less than a full day, those still in a probationary period, part-time, seasonal employees and employees who are rehired. This information must be reported even if the employee is employed for only a few hours before termination. 4. What information must be reported? In accordance with the Federal legislation, the State of Pennsylvania requires the following information to be reported: The employer s Federal Employer Identification Number (FEIN). If the employer has more than one FEIN, use the same one used to report quarterly wage information The employer s name The employer s address 01116-44-02T 080108 1 of 3

A contact person at the employer A phone number for the contact person at the employer The employee s name (full name: first, middle and last) The employee s address The employee s Social Security Number The employee s date of hire The employee s date of birth (optional) The state of hire (optional) 5. How and where is this information reported? The Pennsylvania New Hire Reporting Program offers several options that make it easy for employers to report new hires. The options available are: Electronic Reporting Go to https://www.panewhires.com/login.asp to report any new hires on-line. First time users of Internet reporting must call Customer Service at 1-888-724-4737 to register. Go to https://www.panewhires.com/ftp.asp for instructions on how to send a secure file electronically. Go to https://www.panewhires.com/file_spec.asp for the file specifications on how to send a tape, disk or electronic file with new hire reporting information. For the file layout for tapes and disks, go to: https://www.panewhires.com/file_layout.asp Mail any disks or tapes to the address below. Go to: https://www.panewhires.com/email.asp for instructions and information on sending new hire reports as an attachment to an encrypted e-mail. Non-Electronic Reporting New hire reporting form: Go to https://www.panewhires.com/newhire.pdf to download the form or use the one attached. W-4 form: You may choose to submit a W-4 form as a new hire report. If you do, please ensure that the W-4 is easily readable and has the employer's name, Federal Employer Identification Number, and address written in blocks 8 and 10 on each form. New hire reports may either be faxed or mailed to the following: Mail reports, disks or electronic tapes to: Commonwealth of Pennsylvania New Hire Reporting Program P.O. Box 69400 Harrisburg, PA 17106-9400 Fax reports to: 717-657-HIRE (717-657-4473) Other Reporting Methods Payroll Service: Leading payroll services are already electronically reporting new hires for thousands of employers. If you use one a payroll or accounting service see if the service can report new hires for you. 01116-44-02T 080108 2 of 3

6. How often must the information be reported? Employers are required to submit new hire reports within 20 days after an employee is hired, rehired or returns to work. 7. What is the penalty if the report is late? A penalty of $25 per employee per month may be assessed for each failure to report a new hire. Also, a penalty of $500 may be assessed for the failure to report new hire information if the failure is the result of conspiracy between the business or government entity and the employee. 8. How will the information be used? Federal and State laws contain strict regulations on how new hire reporting information may be used. New hire reporting information is matched against any open child support orders to locate non-custodial parents and enforce these orders. This information will also be fed into a national directory to provide more current information for locating out-of-state noncustodial parents. New hire information may also be used by states to help detect and prevent fraudulent payments to recipients of unemployment insurance, worker s compensation and welfare benefits. The use of this information helps maintain financial stability in Pennsylvania families and helps to keep down the cost of welfare, unemployment and worker s compensation insurance. 9. Additional information. For questions about new hire reporting you can contact the Pennsylvania New Hire Reporting Program Customer Service toll-free at 1-888-PAHIRES (1-888-724-4737). You can also e-mail questions to: reporting@panewhires.com (make sure that the subject line indicates the type of question: for example, electronic file formats, web submissions, FTP, or other questions.) 01116-44-02T 080108 3 of 3

Instructions for Completing the Form Unless noted as optional, all required information must be included on the form. Please type or print legibly in black or blue ink. This form may be duplicated. FEIN: Employer Name: Contact Name: Contact Phone Number: Employee Social Security Number: Date of Birth: Date of Hire: Employee Name: Employee Address: Federal Employer Identification Number Legal name of the employer Person authorized to answer questions on the New Hire Report (this should be someone from the employer) Phone number for the contact person The number assigned by the Social Security Administration Optional Item date of birth for the new hire The first day the new hire performs services for wages First, Middle, and Last name of the new hire Permanent address of the new hire Pennsylvania New Hire Reports may be submitted through the mail or via FAX. Mailing Address: FAX Number: Customer Service Telephone Number: Commonwealth of Pennsylvania New Hire Reporting Program PO Box 69400 Harrisburg, PA 17106-9400 717-657-HIRE 717-657-4473 1-888-PAHIRES 1-888-724-4737

217 COMMONWEALTH OF PENNSYLVANIA New Hire Reporting Form Required Employer Information FEIN: Please mail or fax to: Employer Name: Commonwealth of Pennsylvania New Hire Reporting Program Address: P. O. Box 69400 Harrisburg, PA 17106-9400 Contact Name: Contact Phone #: Fax: 717-657-HIRE (717-657-4473) Phone: 1-888-PAHIRES (1-888-724-4737) (for questions only) This form can be duplicated Required Employee Information (Please type or print legibly in black or blue ink.) Employee Social Security # Date of Birth (mm/dd/yyyy) optional Date of Hire (mm/dd/yyyy) Name (first) (middle) (last) Address City State Zip Employee Social Security # Date of Birth (mm/dd/yyyy) optional Date of Hire (mm/dd/yyyy) Name (first) (middle) (last) Address City State Zip Employee Social Security # Date of Birth (mm/dd/yyyy) optional Date of Hire (mm/dd/yyyy) Name (first) (middle) (last) Address City State Zip New Hire Reporting Lending a Hand to Pennsylvania's Children Commonwealth of Pennsylvania Department of Labor and Industry Center for Workforce Information and Analysis Pennsylvania New Hire Reporting Program - 5