Electronic Reporting Specifications

The following tables detail the employee and employer information required for electronic reporting, as well as optional information.

Required Employee Information	Required Employer Information
Employee's full name	Employer's name (please use corporate name)
(Please identify first, middle, and last name)	Employer's name (please use corporate name)
Employee's address	Employer's address (please provide address where Income Withholding Orders should be sent.)
Employee's Social Security Number	Employer's Federal Employer Identification Number (FEIN). If you have more than one FEIN, please make certain you use the same FEIN you use to report your quarterly wage information when reporting new hires.
Employee's date of hire	Reemployment assistance identification number (if applicable)
Employee's state of hire (only if reporting as a multistate employer)

Optional Employee Information	Optional Employer Information
Employee's date of birth	Employer's phone number
Employee's state of hire	Employer's fax number
	Employer's email address
	Employer’s contact (individual’s name)
	Medical insurance availability