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First Time (Initial) Employer Report Form (PC-1) 


If you are applying for an IDHR Employer Eligibility Number for the First Time, there will be a $75.00 non-refundable fee.  The number expires five (5) years after the date of issue and may be renewed at that time for an additional $75.00 fee.

NO BUSINESS OR PERSONAL CHECKS WILL BE ACCEPTED   --- only cashier’s check, certified check, or money order will be accepted and processed.  All forms accompanied by a business or personal check will be returned unprocessed.  Also, at this time, we do NOT accept credit cards for first time applications.

If your company has multiple locations with the same FEIN as the corporate headquarters, the corporate headquarters for the company must submit via regular mail a First Time (Initial) Employer Report Form (PC-1) for all Illinois locations it wishes to register. No additional fee is required.

Definitions, Clauses & Policies — (PC-1 Form) (Please read before filling out the form)

First Time Employer Report Form (PC-1) (pdf format)
(First time applicant beginning January 1, 2010)


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