NEW HIRE REPORTING INFORMATION
DEPARTMENT OF HEALTH AND HUMAN SERVICES
CHILD SUPPORT
SFN 1018 (6-2023)
Date
Mail to:
Child Support
Department of Health and Human Services
PO Box 7190
Bismarck, ND 58507-7190
Fax to:
Child Support
Department of Health and Human Services
Fax #: (701) 328-5497
Total Pages Faxed:
OR
All Employers Must Report All New Hires
This form may only be used by employers with 24 or fewer employees.
24 or fewer employees - complete this form or visit www.childsupportnd.gov to report new hires electronically.
25 or more employees - report new hires electronically. Visit www.childsupportnd.gov to learn more and to report
new hires.
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Part 1: Employer Information
Employer Name
For SDNH office use only
Address
City
State
ZIP Code
Federal Employer Identification Number
Part 2: Employee Information
Employee Name Employee Address
Employee Social
Security Number
Health
Insurance
Offered to this
Employee?
Employee
Date of Hire
Employee
Date of Birth
(optional)
1
Yes
No
2
Yes
No
3
Yes
No
4
Yes
No
5
Yes
No
Disclosure of the social security number is required pursuant to 42 USC 653a(b)(1)(A) and is requested for the purpose of data matching with the state
case registry. Failure to disclose this information will affect compliance with new hire reporting requirements.
(Use continuation sheet to report additional new hires.)
Employer Representative
Telephone Number
INSTRUCTIONS FOR COMPLETING THIS FORM MAY BE FOUND ON THE REVERSE SIDE
Clear Fields
SFN 1018 (6-2023)
Page 2 of 3
INSTRUCTIONS FOR COMPLETING THE NEW HIRE REPORT
This form may only be used by employers with 24 or fewer employees to report new hires.
Employers with 24 or fewer employees may report new hires on this form or electronically.
Employers with 25 or more employees must report new hires electronically.
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Visit www.childsupportnd.gov to learn more and to report new hires. A waiver of the electronic reporting requirement may
be requested by contacting Child Support.
Step 1: Enter the date you will be mailing or faxing the form. If faxing, also enter the number of pages.
Under Part 1:
Step 2:
Step 3:
Step 4:
(REQUIRED) Enter the employer's name.
(REQUIRED) Enter the employer's address. Be sure the address is complete, including street address or PO
Box, and city, state, and ZIP code.
(REQUIRED) Enter the Federal Employer Identification Number. This is also referred to as an EIN, FEIN, or
Federal tax identification number. This is the same number as Box 10 of the W-4 form.
Under Part 2, for each newly hired employee:
Step 5:
Step 6:
Step 7:
Step 8:
Step 9:
Step 10:
Step 11:
(REQUIRED) Enter the employee's name.
(REQUIRED) Enter the employee's address. Be sure the address is complete, including street address or PO
Box, and city, state, and ZIP code.
(REQUIRED) Enter the employee's social security number.
(REQUIRED) Enter "Yes" if you offer health insurance to the employee. Enter "Yes" even if the employee is
subject to a waiting period for the health insurance. Enter "No" if you do not offer health insurance to the
employee.
(REQUIRED) Enter the employee's date of hire. The date of hire is the employee's first day of work for pay.
(OPTIONAL) Enter the employee's date of birth.
(REQUIRED) Enter the name and telephone number of the employer representative and send the completed form
to the address or fax number on the top of the form. If faxing the form, do not also mail it. Please be sure the
correct side of the form is faxed.
What is a newly hired employee?
A newly hired employee is an employee who was not previously employed by you or was previously employed by you but
was separated from that previous employment for at least 60 days in a row and has now returned to work for you.
How do I know if I am an employer who needs to report new hires?
The definition of "employer" for new hire reporting purposes is the same definition used for federal income tax wage
withholding purposes (as defined by section 3401(d) of the Internal Revenue Code of 1986) and includes any governmental
entity and any labor organization. As a general rule, if an employer is required to give an employee a W-2 form showing the
amount of taxes withheld, the employer must comply with the new hire reporting requirements.
How do I know if the person I just hired needs to be reported?
The definition of "employee" for new hire reporting purposes is the same definition used for federal income tax wage
withholding purposes (as defined by Chapter 24 of the Internal Revenue Code of 1986). As a general rule, if an employee
is given a W-2 form showing the amount of taxes withheld, that employee fits the definition for new hire reporting.
When must I report?
The report must be made no later than 20 days after the employee's date of hire.
If you have any questions, please contact:
Child Support
Department of Health and Human Services
PO Box 7190
Bismarck, ND 58507-7190
Telephone: (701) 328-6524
For TTY service: 711
IF YOU WOULD LIKE TO RECEIVE THIS FORM IN AN ALTERNATE FORMAT (SUCH AS LARGE
PRINT OR BRAILLE), PLEASE CALL 701-328-6524 TO MAKE ARRANGEMENTS.
Your cooperation helps our nation's children - Thank You !
SFN 1018 (6-2023)
Page 3 of 3
Page
of
NEW HIRE REPORTING CONTINUATION SHEET
(Use this sheet to report additional new hires.)
Date
Employer Name
Telephone Number
Employee Name Employee Address
Employee Social
Security Number
Health
Insurance
Offered to this
Employee?
Employee
Date of Hire
Employee
Date of Birth
(optional)
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
