National Incident
Management System (NIMS) Compliance Training
National Integration Center
(NIC)
Emergency Management
Institute (EMI) - Independent Study Program (ISP)
What NIMS Courses Do I Need? (NIMS Training Guidelines)
Personnel Forms
W-4 Tax Deduction Change (Federal)
NC-4 Tax Deduction Change (State)
Payroll Deduction Change
Direct Deposit Change
Dental Claim
Hepatitis B Informational and Declination Statement
Leave Request
FMLA Employee
Rights and Responsibilities Poster
FMLA
Notice of Eligibility and Rights & Responsibilities (employer to
complete, this is only a sample)
FMLA
Designation Notice (employer to complete, this is only a sample)
FMLA
Fact Sheet #28: The Family and Medical Leave Act of 1993
FMLA Certification
of Health Care Provider (for employee's serious health condition)
FMLA
Certification of Health Care Provider (for family member's serious
health condition)
FMLA
Fact Sheet #28A: The FMLA Military Family Leave Entitlements
FMLA
Certification of Qualifying Exigency for Military Family Leave
FMLA
Certification for Serious Injury or Illness of Covered Servicemember for
Military Family Leave
Short-Term Disability Application
(see below section for additional disability benefits for sworn officers)
Death & Disability Income Benefits for LEOs Application - provided by Separate Insurance
Benefits Plan
Personnel Action Form (PAF) – for name/address/phone
#
changes only
Employee
Warning Report / Disciplinary Action
Exit Interview
Benefits Forms
COBRA Notification of Rights (informational handout)
Blue Cross Blue Shield of NC Enrollment/Change Form
Blue Cross Blue Shield of NC Claim Form
Dental Enrollment/Change Application
Dental Claim
NC League of Municipalities
Beneficiary Change Form
401K Enrollment Form
401K Beneficiary Form
401K Name Change
401K Address and Contribution Rate Change
Retirement System Beneficiary Form
Retirement System Benefits Handbook
Retirement System Benefits Calculator
Special
Separation Allowance Application
LEO
Separate Insurance Benefits Plan Beneficiary Form
SportsCenter Enrollment Form ($29 Employee, $40 Couple, $48
Family)
SportsCenter Payroll
Deduction Enrollment/Cancellation Form
Benefit Contact Numbers/Links
BCBS of NC (medical/vision plan)
NC League of Municipalities (life, short-term disability,
supplemental life, dependent life, workers comp, liability)
401K
Retirement System
SportsCenter
AFLAC – Duane L. Wells, Agent: 252 726-5936, Fax: 252 247-2167
Carolina EAP – Tony Howard, EAP Provider: 252 671-5898,
howard1@cconnect.net
General Forms
Travel Advance
Travel Expense Reimbursement
Check Request
Purchase Order Request
W-9 Request (required for new vendors)