Personnel Documents

Employment Application

Employment Application


NCDOR Labor Law





Personnel Policy


Tax Forms

W-4 Form (Federal Tax Withholding)

NC-4 EZ Form (State Tax Withholding)


Direct Deposit

Direct Deposit Form

Direct Deposit FAQs


E-Verify Forms

Employment Eligibility Verification Form (I-9)

I-9 Instructions

I-9 Supplement


Family Medical Leave Act (FMLA)

WH-380-E  Certification of Health Care Provider for Employee’s Serious Health Condition

WH-380-F  Certification of Health Care Provider for Family Member’s Serious Health Condition

WH-381      Notice of Eligibility and Rights & Responsibilities

WH-382      Designation Notice

WH-384      Certification of Qualifying Exigency for Military Family Leave

WH-385      Certification for Serious Injury or Illness of a Current Service member

WH-385-V  Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave


Insurance Forms

Employee Benefit Synopsis

MedCost – Health Insurance  (1-800-217-5097)


MetLife – Dental Insurance (1-800-275-4638)


AlwaysCare – Vision (1-888-729-5433)


Transamerica - Life Insurance (1-888-763-7474)


AFLAC – Supplemental Insurance (1-800-992-3522)


USABLE - Short-term Disability, Long-term Disability, Accidental Death & Dismemberment (AD&D), Life Insurance - (1-800-370-5856)


Retirement Contacts


401k - Prudential Retirement


457b - Prudential Retirement


NC Local Government Retirement System



Fax: 910.428.2419


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110 West Main Street Biscoe, NC 27209  | (910) 428.4112