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Employer Accounts

 

 

Use this form to ask questions regarding tax rates, benefit charges or any other employer account topic. Please do provide your whole name, company name, email address and phone number so that someone may contact you, if necessary.
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1.   Your Full Name    (Type Answer) **Required
 
(100 character limit; 100 remaining.)
 
2.   Company Name    (Type Answer)
 
(100 character limit; 100 remaining.)
 
3.   NHES Account Number    (Type Answer)
 
(100 character limit; 100 remaining.)
 
4.   City/Town    (Type Answer)
 
(100 character limit; 100 remaining.)
 
5.   Your Email Address    (Type Answer)
 
(100 character limit; 100 remaining.)
 
6.   Your Telephone Number (Example: 999-111-0000)
  Ext:
 
7.   Your Comment/Question    (Type Answer)
 
(500 character limit; 500 remaining.)
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