Fillable PRWORA Form The Personal Responsibility and Work Opportunity (Metropolitan State College of Denver)

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PRWORA Form The Personal Responsibility and Work Opportunity (Metropolitan State College of Denver)

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PRWORA Form
The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996, known as
welfare reform, require all employers to report certain information on their newly hired employees to a
designated state agency within time parameters.
For additional information, visit the U.S. Department of Health and Human Services, Administration for Children
and Families website:
http://www.acf.hhs.gov/programs/css/resource/new-hire-reporting-answers-to-employer-questions
PLEASE PRINT LEGIBLY IN BLACK OR BLUE INK:
Name:
Social Security Number:
Address:
City, State, Zip:
For Human Resources:
Hire Date:
TO: Colorado Department of Human Services
FROM: Metropolitan State University of Denver
P.O. Box 173362, Campus Box 47
Denver, CO 80217-3362
Federal Employer I.D. Number: 84-0559160
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PRWORA Form The Personal Responsibility and Work Opportunity (Metropolitan State College of Denver)

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Completed 18 September 2020

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