Full-Time New Hires & All Benefit-Eligible New Hires-Required Forms

You must present required documents to HR no later than the beginning of your shift on your first day of work. Please note that some forms are "fillable" but still must be printed and signed to submit to HR.

Instructions

1. Complete, print and sign all “Full-time Required Paperwork”
2. Read/review all “Supplemental/Optional Benefits” and complete enrollment forms only for those optional benefits for which you wish to enroll
3. Turn all required documents, plus any optional benefits you elect into Human Resources on or prior to the start of your shift on your first day of employment. Note:  In order to be able to legally begin employment, you must present Human Resources with the required Form I-9 documents on or prior to the start of your shift on your first day of employment;  therefore, please see p.3 of Form I-9 for document options.

Full-Time Required Paperwork

• Form I-9 - Employment Eligibility Verification - Department of Homeland Security
• W-4 - Federal Tax withholding form
• NC-4EZ - North Carolina State Tax withholding form
• Direct Deposit Form
• Emergency Contact Information
• County Manager's Directive Memo - Procedure to Report and Resolve Operational or Personnel Problems
• Electronic W-2 Consent Form
• Employee Self-Identification Race/Ethnicity Form
• Key Policy Acknowledgement Form- This must be signed and turned in after reading the:
  • Personnel Policy
  • Safety Handbook
  • Workplace Harassment Policy 5.08 - 10.04
• Prior Service Credit(only if you've worked for Government previously)
• CEC Vision Insurance/Community Eyecare Enrollment/Waiver Form - For more information, please review CEC Vision Plan Summary first.
• Form 2C - Designating Beneficiary(ies) for NC Retirement Plans
• Health and Dental Insurance Election and Payroll Authorization/Waiver Form
• BlueCross BlueShield of NC PPO or HSA Health Insurance Enrollment Form - For more information, please review BlueCross BlueShield PPO and HSA Plan Summaries.
• Ameritas Dental Enrollment/Change/Waiver Form - For more information, please review the Ameritas Dental Plan Summary.
• The Patient Protection and Affordable Care Act, "New Health Insurance Marketplace Coverages Options and your Health Coverage OMB No. 1210-0149" Acknowledgement Form
• Dearborn National Beneficiary Designation Form - Free $15,000 term life and AD&D insurance - For more information, please review the Dearborn Life Insurance Plan Summary and the Dearborn Employee Benefit Booklet.
• SWORN LAW ONLY - Prudential 401(k) Enrollment Form

Supplemental/Optional Benefits & Plan Summaries

You only need to complete these if you wish to elect any of the benefits in this section

• Ameriflex FSA Enrollment Form - For more information, please review the Ameriflex FSA Plan Summary
• Colonial Life Supplemental Product Enrollment Form & Contact Info - For more information, please review the Colonial Life Supplemental Plan Summaries.
• Nationwide 457(b) Enrollment Form - You must also fill out Nationwide Insurance Contact Info if you select this benefit. For more information, please review Nationwide 457(b) Plan Summary.
• Empower NC 401(k) and NC 457(b) Tools
• Reliance Standard Enrollment Form - For more information, please review Reliance Standard Premium Rate Table.

Paperwork for your records/files

• Burke County Benefit Summary
• Burke County Payroll Schedule
• Burke County Holiday Schedule
• Discounts
• The Counseling Group - Employee Assistance Program Brochure
• Burke County Employee Health and Wellness Clinic (UNC Health Blue Ridge)—WELLWORx Brochure