Electronic address change form for Benefits plans, employee must log into form with Unity Account User ID and password

For employees to terminate coverage with Liberty Mutual

For employees to change name or address with Liberty Mutual

To enroll in the Liberty Mutual Plan

Statement of health questions for employees to enroll in Liberty Mutual during the year and annual enrollment

To enroll in the Standard Insurance Plan

Statement of health questions for employees to enroll in the Standard Insurance during the year

State Health Plan Forms such as authorization, reimbursement, prescription drug order

For Post Doc's to enroll in the Post Doc Health Insurance

To make coverage changes on the State Health Plan

This is a sample letter that the department head can use when responding to the academic year employee's request for FML.

Complete this form when requesting Family Medical Leave.

This is a sample letter that the supervisor can use when responding to the employee's request for FML.

Complete this form when requesting Family Illness Leave.

This is a sample letter that the supervisor can use when responding to the employee's request for FIL..

This form must be completed by your health care provider and attached to your application for Family Medical or Family Illness Leave.

Complete this form to request Scholarly Leave Assignments.

Complete this form when requesting Shared Leave.

Complete this form to donate Shared Leave to a participant in the Shared Leave program.

To enroll in the MetLife Insurance

Statement of health questions for employees to enroll or increase coverage in the MetLife Insurance during the year

To submit a cancer claim

To convert Cancer plan to home billing once employee separates Emp

To submit a dental claim

To enroll in NC Flex plans

Authorize others to access information on Dental, NC Flex Spending Accounts, Supplemental Medical, and the Vision Plan

To make coverage changes to NC Flex plans

To update beneficiary NC Flex Term Life Insurance

To convert Term Life plan to home billing once employee separates Emp

To process a death claim for NC Flex Term Life Insurance

Completed when over $100,000 in coverage requested for new hires, or during the annual enrollment to add or increase coverage

To enroll in the NC Flex spending accounts convenience card

To make a claim on the NC Flex Flexible Spending Accounts or to send in Convenience Card receipts.

To enroll dependents to have a NC Flex spending accounts convenience card

To enroll in NC Flex plans online

To submit Supplemental Medical claim

Electronic form for Campus Department to complete to enroll a new hire in New Employee Orientation

Elect to continue or cancel benefit plans while on Phased Retirement

To enroll in the Phased Retirement Program

Completed by Phased Retirment applicant to identify they are entering the Phased Retirement Program of their own choice

To enroll in the Legal plan

Electronic form to nominate employees for the Pride of the WolfPack Award

Submitted by Departments for Employees that are retiring and request a retirement certificate

Media Release form all winners of the University Awards for Excellence complete before their information is listed in the press and online

Completed to nominate an employee for the Awards for Excellence program

Electronic form for potential businesses that want to participate in the WolfPerks employee discount program

ORP-3 Acknowledgement for Disposition of Account Contributions-Completed once employee seperates Emp to verify vesting status with ORP program

NC Department of State Treasurer Forms Page

To apply for retirement with the State Retirement System or Law Enforcement Officer Retirement System

ORP-4 Authorization for coverage with the State of North Carolina Retired Group Health Plan-For retired employees with ORP to continue the heatlh plan in retirement

Direct Deposit form for retire benefit

1A-Election form the ORP-to enroll in the ORP plan

To change beneficairy or address information for the Law Enforcement Officers Retirement System

To enroll and list beneficiary information for Law Enforcement Officers Retirement System

Completed to identify retirement date for Medicare on retirees age 65 and older

2A-Change in Investment election for ORP-Change future ORP contibutions between the four vendors

To request an estimate of retirement for the State Retirement System and Law Enforcement Officers Retirement System

To request a refund of retirement contributions (on termination) for the State Retirement System and Law Enforcement Officers Retirement System

For retirees age 65 and older to apply for Medicare coverage

To enroll in the Retiree State Health Plan

To change beneficairy or address information for the State Retirement System

To enroll and list beneficiary information for State Retirement System

Federal and State Tax witholding form for retirement benefit

Application for the Faculty and Staff tuition waiver

To change address or contribution to the 401(k) plan

To enroll in the 401(k) plan

To start or change payroll deduction for the 403(b)

To start or change payroll deduction for the 457 Deferred Comp plan

Utilizado por un empleado divulgar lesión o una enfermedad profesional a la Comisión industrial.

Employees description of work related accident and injury, including employees choice to use leave during the seven day waiting period for Workers' Compensation.

To report an employee's injury or occupational disease to the Industrial Commission

Completed to report work related injury, illness, or near miss

Physician completes for a Workers Compensation situation

Used by an employee to report an injury or occupational disease to the Industrial Commission.

Complete this form for creating a new or changing the title of a career banded position.

Complete this form to request a salary adjustment for an employee in a career banded position.

Complete this form for employees that are career banded to assess their competencies or request a level change.

Form required for additional compensation approval

Analysis Tool for FSLA Exemption

Complete this form to assist in determining if a position qualifies for EPA status as Instructional or Research Non-Faculty

Personnel Action requiring approval of the Board of Govrnors and/or the Board of Trustees

Complete this form to request a change in title and/or salary for an existing EPA position.

Complete this form to create a New EPA Position

Complete this form for position action requests on classification series such as Accounting Clerks, Accounting Technicians, Accounting Specialists

Complete this form for position action requests on classification series such as Administrative Assistants, University Administrative Managers

Complete this form for position action requests on all other classification series

Complete this form with budget data information for an Accounting Support position

Complete this form to indicate the physical efforts required by a specific position.

Complete this form with budget data information for an Administrative Support position

Complete this form with additional information for an Ag Research Support position

This form covers job change, temp job change, equity, and labor market adjustments. Complete this form to request an in-range salary adjustments for SPA positions.

Provides an outline of what to expect during the interview/audit process of a position action review

Complete this form for Status Change, FTE Change, and Abolishment requests

Complete this form with budget data information for a Student Services Support position

used by supervisors as a guideline to write a demotion letter for an SPA employee.

used by supervisors as a guideline to write a dismissal letter for an SPA employee.

Template used to dismiss a Probationary SPA Employee

used by supervisors as a guideline to write a suspension without pay letter for an SPA employee.

used by supervisors as a guideline to write a writing warning for an SPA employee.

This Form should be used to track University assets that are assigned to the individual for authorized business use. The form should be reviewed when an individual separates from the University to ensure proper asset retrieval.

used to collect information that contributes to retention and turnover, and provides exiting employees an opportunity to voice concerns and make suggestions. Must be completed by all exiting employees.

Online questionnaire used to collect information that contributes to retention and turnover, and provides exiting employees an opportunity to voice concerns and make suggestions. Must be completed by all exiting employees.

This form ensures retrival of University assets from exiting employees. It provides both exiting employees and their supervisors with guideliness needed to complete the separation proccess.

used to file a formal SPA Grievance.

Must be completed by employees interested in becoming SPA Grievance Panel Members.

To file for a review of a performance pay issue or a performance evaluation rating.

This form provides mediation participants basic information about limits of the mediation process. It is provided by the Program Coordinator and/or the mediators at the time of mediation. Participant signatures are required. The completed form is maintain

This form outlines the expectations of Program mediators, and serves as an agreement for mediators to participate in the University Mediation Program.

This form provides a format for parties to document agreements developed during the mediation session. It is retained by the parties.

This handout serves as a confirmation of the scheduled mediation and provides an overview of the mediation process. It is provided to the parties prior to the mediation sessions by the Program Coordinator or the mediator(s).

optional replacement for the Key Responsibilities Summary.

Outlines Key Responsibilities and Expected Levels of Performance for Career Banded positions.

Form used to establish annual work plans and evaluate an SPA employee's competencies and performance in BANDED POSITIONS.

used to establish annual work plan and to evaluate an SPA employee's performance.

must be completed by the employee, supervisor, and appropriate level of management prior to an employee transferring to another state agency or department on campus.

Supplies demographic, Selective Service and other information for new EPA employees

Lists documents required to enter a new, non-paid employee into the HRIS

Lists documents required to enter a new, paid employee into the HRIS

Lists documents required to rehire both paid and non-paid employees

Lists documents for which completion is necessary at the time of an employment offer

Coversheet for submitting an action to enter/update the I-9 fields in the HRIS

Provides a list of possible required documents for current employee job requests

Lists documents required to update personal data information in the HRIS

Lists documents required to terminate separating/retiring employees

Used to track applicants for EPA vacancies.

To be completed and approved before making an offer to the final candidate for EPA vacancies.

To be completed and approved before conducting interviews for EPA vacancies.

To notify all candidates not hired for EPA vacancies.

Template letters required to offer EPA employment

To guide hiring officials through the recruitment and selection process of EPA vacancies.

Used to hire EPA employees in exceptional circumstances when usual search process is not followed.

Used to appoint short-term (1-2 year) appointments for EPA vacancies or for Post-Docs (up to 5 years).

To be completed in order to post an EPA vacancy.

A form to confirm understanding of NC State Patent and Copyright Procedures.

Fill out this form to certify Temporary Employee understands the terms of employment.

Regular faculty, special faculty, EPA non-faculty professionals, post-docs, EPA time limited, EPA waiver appointments, SPA staff hires & transfers

For all employees and students going on payroll to document Emp eligibility in the United States.

To be completed and reviewed will all new employees.

A one page checklist for things that will need to be done for each new employee. (Your may have additional items specifcally for your unit.)

A list of permissible inquiries and those that should be avoided during the recruitment process.

A list of sample questions that may be asked during interviews.

Selective Service Registration Certification for Male Temporary and Graduate Student Workers

Guidelines for hiring officials when completing Emp references for new employees.

A one page checklist to guide hiring officials through the staff recruitment process.

Sent to applicants who were interviewed but not selected.

Completed at time of hire for new staff employees

Staff (SPA) employees must complete this form prior to accepting secondary Emp.

To guide hiring officials through the recruitment & selection process for staff vacancies.

Completed at time of hire for staff employees hired under Time-Limited status

Fillable Non-UTS temporary employee application

To payout Annual and Bonus leave for EPA and SPA Employees.

Instructions on how to find and use the online Personal Data Form (PDF), Job Data, Personal Data, and Education/Contract Forms.

This document lists the begin and end dates for the permanent timesheet for employees paid monthly.

Filled out by employing department listing minimum job requirements and salary for the H-1b position. Filled out with the Actual Wage Statement.

Filled out by employing department listing all similarly employed people in department in same position as the H-1b sponsored emloyee.

Used by employing department to formally ask I.E. to start H-1b process on an employee.

Used by employing department to formally ask I.E. to start Permanent Residency process on an employee.

Notice that must be posted in two places within department for 10 days for the H-1b process.

Filled out by employing department to list minimum job qualifications for the position for an H-1b visa.

This sample letter is separate from the official, original appointment or the offer letter, and does not have to coincide with appointment dates. It is for H-1B time period requests to USCIS only.

Complete this form to change your home address with the Payroll Office

Complete this form to add/change/delete CDC locations

Complete this form to cancel some payroll deduction

Complete this form to enroll in, change or cancel your direct deposit

Complete this form to enroll in, change or cancel your direct deposit

Complete this form when you have an employee who will be working outside North Carolina for any part or all of their employment. This form must be completed prior to departure and upon return if applicable.

Complete this form to request a replacement check for a lost/stolen/destroyed payroll check

Departments complete this form to request a manual check.

Complete this form to request that your pay statements be printed each payday because you do not have access to a computer to print them.

Departments complete this form when returning a paycheck