The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02

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Here is the text we could read:

" 

STATE  OF  ALABAMA,  DEPT.  OF  INDUSTRIAL RELATIONS 
EMPLOY.ERFEIN  636000619 

03911 

EMPLOYER  NAME  ADMIN  OFFICF  OF  COURTS 

NEW  HIRE  REPORTING  FORM  (NH-1,  Rev  9/97) 

MARK ONE OFTHE FOLLOWING  BOXES:  New Hire D  Recall  D Job  Refusal D 

Mark box  like this 

rv'I 
IClI 

NOT  IAI  M  ~ 
like this ~  b!.I  ~ 

SOCIAL SECURITY NUMBER 

E ITO - CD-ITIJ] 

FIRST DAY OF WORK 
(OR DATE OF  REFUSAL) 

EMPLOYER  REPRESENTATIVE  PHONE  NUMBER 

[fJ1~  [Q][Q]  [~]~[I~ 

(ITO) ITO-ITIJ] 

LAST NAME 

STREET NUMBER 

1 
2  ITIIJJJJ 
3 
lI:iiiIii1iI Signature 

CITY 

FIRST NAME 

STREET NAME OR  RURAL  ROUTE AND NUMBER 

MI 

D 
OR  ITIIill

P.O.  BOX  NUMBER 

STATE 

ZIP CODE 

CD  ITIIJJ 

THE ABOVE  INFORMATION  IS TRUE AND CORRECT 

PLEASE  MAKE YOUR  CHARACTERS  LIKE THE  SAMPLES  BELOW: 

Date 

Date 

SECTION  E  - Employer  should  enter  or  verify  social  security 
number,  first  day  of  work,  and  whether  new  hire,  recall  or  refusal. 

(Job-refusal  reports  should  be  completed  in  their  entirety  by  the 

employer,  including  phone  number.) 

SECTIONS  1,  2,  and  3  - May  be  completed  by  the  employer 
or  employee.  Enter  employee  information  indicated  on  the  report 

form  as  shown  by·  the  example. 

The  form  must  be  signed  by  the  employee  (if  available)  and  the 

employer  (or  representative)  except  for  job  refusals,  which  require 

only  the  employer's  signature. 

COMPLETE  ONE  FORM  PER  INDIVInUAL,  PRINT  IN  UPPER  CASE  LETTERS, 
WRITE  WITHIN  THE  BOXES,  AND  USE  ONLY  BLACK  OR  BLUE  INK. 

· ,~ 

Employers  are  required  to  furnish  new  hire  and/or  recall  information  to  the  Alabama  Department  of  Industrial 
Relations,  beginning October 1J  1997, within seven  (7)  days of the first day of work,  per Act 97-228,  New Hire Act 
of 1997.  This information will be entered into the Alabama Directory of New Hires to help prevent program abuse 
and to assist the  Federal  Parent Locator Service,  as  required by  Public Law 104-193.  A penalty of up to $25 may 
be  assessed per failure to  report  New Hire data.  New Hire data should be  MAILED TO: 

Alabama  Department of Industrial  Relations 
New Hire Unit 
649  Monroe Street,  Room  283 
Montgomery, AL 36131-0283 

(This form is designed to fit a standard  No.1 0 windowed envelope.)

New Hire Reporting Form

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Alabama state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from eforms.alacourt.gov (2023-03)
Page(s): 2
Fields(s): 121
Average fields per page: 60
Reading Level: Grade 8
LIST Grouping(s): WO-03-00-00-00, BE-04-00-00-00, WO-00-00-00-00, WO-02-00-00-00.

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Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

New Hire Reporting Form

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02