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Report New Hire/Separation of Employment

As an employer, you have a legal responsibility to report new hires to the EDD New Employee Registry. Reporting a new hire on this site does not fulfill your obligation to report the new hire. Please visit the following link for more information.

Help us expedite your request for a: (check appropriate boxes)

 
 

Please provide the following information:

Employer Information ( * indicates required information)

* Business name:    
* City:    
* State:    
Zip Code:  
* Phone Number:    
E-mail Address:  

Employee's Name

Name:  
Date of Birth:  
Social Security Number:  
Date of Hire/Separation:  
Employee Address:  
City:  
State:  
Employee Phone Number:  
Employee Cell Phone:  

Comments

Remarks/Comments: