Register

Use this form to register your company for online access to Indiana New Hire Program Services.

*Note: Fields marked with an asterisk indicates required fields.

Company Information

*Company Name

*Federal Employer Identification Number9 digits, do not include dashes or spaces

* Password Your password must be at least 8 characters long.
Your password must utilize at least three of the following four:

* Password Verification You must retype your exact password in this space

* Address
Please enter the Employer's
address used for the processing
of Income Withholding Orders Address 2 Address 3

* City

State

Other(two-letter abbreviation) State

* Zip Code Zip Code Extension

Country

* Country

Is the company less than one year old?

Offer Medical Insurance?

Company's website url

Number of Employees

Industry Type

Payroll Provider

If you are a PAYROLL PROVIDER (or Service Bureau) registering YOUR OWN ACCOUNT (through which you will report for other employers), use this form, and be sure to click the Payroll Provider check box below.
If you are NOT A PAYROLL PROVIDER and WILL NOT REPORT FOR OTHER EMPLOYERS, use this form, and do not click the Payroll Provider check box below.

Yes

Payroll Provider

Contact Information

* First Name: First name must be at least 2 characters long

* Last Name: Last name must be at least 2 characters long

Contact Title

* Phone: Phone number must be 10 digits

Fax: Fax number should include leading zero followed by area code

* Email

Contact Preference

Reporting Preference