*Please return all completed form to Human Resources

Payroll Forms

• Direct Deposit Enrollment/Change Form 
• NC-4 Tax Form 
• W-4 Tax Form
• Payroll Adjustment Form

Retirement Forms 

• NC Retirement System Forms 
• Prudential 401K Forms 
• ICMA 457 Forms
• ICMA 457 Loan/Refinance Packet

Insurance Forms

• Insurance Change Form for Qualifying Life Events -add/remove dependents or change coverage 
• HSA Contribution Change Form 
• FSA Enrollment Form 
• FSA Status Change Form 
• FSA Direct Deposit Form 
• UNUM Supplemental Benefits Change Form 
• The Hartford (Life, LTD) Enrollment Form
• The Hartford (Life, LTD) Beneficiary Designation 
• Ameritas Vision Change Form 

Miscellaneous

• Change of Address Form / Emergency Notification Form 
• Sick Leave Bank Election Form 
• Sick Leave Bank Withdrawal Form 
• Outside Employment Verification Form 
• Application for Educational Assistance
• Request for FMLA leave (return form to supervisor)
• Certification of Health Care Provider for Employee's Servious Health Condition (380-E)
• Certification of Health Care Provider for Family Member's Servious Health Condition (380-F)
• Cell Phone Stipend
• Wellness Exercise Tracking Form

Recruitment Forms

• Criminal History Release
• Driving History Release