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!["North Carolina New Hire Reporting Form" - North Carolina](https://data.templateroller.com/pdf_docs_html/1999/19995/1999522/north-carolina-new-hire-reporting-form-north-carolina.png ""North Carolina New Hire Reporting Form" - North Carolina")
"North Carolina New Hire Reporting Form" - North Carolina
Size: 72 KB
1 page
This is a document that is used by employers in the state of North Carolina to report information about their employees who have been newly hired, rehired, or have returned to work.
![Peer/In-Reach Form A "North Carolina Transitions to Community Living Initiative Informed Decision-Making Tool" - North Carolina](https://data.templateroller.com/pdf_docs_html/2356/23566/2356677/peer-in-reach-form-a-north-carolina-transitions-to-community-living-initiative-informed-decision-making-tool-north-carolina.png "Peer/In-Reach Form A "North Carolina Transitions to Community Living Initiative Informed Decision-Making Tool" - North Carolina")
![Form DVR-VF2 "#00969 Community Rehabilitation Program Renewal Vendor Application" - North Carolina](https://data.templateroller.com/pdf_docs_html/2152/21522/2152218/form-dvr-vf2-00969-community-rehabilitation-program-renewal-vendor-application-north-carolina.png "Form DVR-VF2 "#00969 Community Rehabilitation Program Renewal Vendor Application" - North Carolina")
![Form DVR-VF1 "#00969 Community Rehabilitation Program New Vendor Application" - North Carolina](https://data.templateroller.com/pdf_docs_html/2152/21522/2152217/form-dvr-vf1-00969-community-rehabilitation-program-new-vendor-application-north-carolina.png "Form DVR-VF1 "#00969 Community Rehabilitation Program New Vendor Application" - North Carolina")
![Form 8 "Nurse Aide I Training Faculty Requirements Worksheet" - North Carolina](https://data.templateroller.com/pdf_docs_html/413/4139/413930/form-8-nurse-aide-i-training-faculty-requirements-worksheet-north-carolina.png "Form 8 "Nurse Aide I Training Faculty Requirements Worksheet" - North Carolina")
![Peer/In-Reach Form A "North Carolina Transitions to Community Living Initiative Informed Decision-Making Tool" - North Carolina](https://data.templateroller.com/pdf_docs_html/2103/21039/2103991/peer-in-reach-form-a-north-carolina-transitions-to-community-living-initiative-informed-decision-making-tool-north-carolina.png "Peer/In-Reach Form A "North Carolina Transitions to Community Living Initiative Informed Decision-Making Tool" - North Carolina")
![Individual Form B "North Carolina Transitions to Community Living Initiative Informed Decision-Making Tool" - North Carolina](https://data.templateroller.com/pdf_docs_html/2103/21039/2103990/individual-form-b-north-carolina-transitions-to-community-living-initiative-informed-decision-making-tool-north-carolina.png "Individual Form B "North Carolina Transitions to Community Living Initiative Informed Decision-Making Tool" - North Carolina")
![Formulario DAAS-101 "Formulario Para Registro Del Cliente (Version Corta)" - North Carolina (Spanish)](https://data.templateroller.com/pdf_docs_html/2317/23179/2317939/formulario-daas-101-formulario-para-registro-del-cliente-version-corta-north-carolina-spanish.png "Formulario DAAS-101 "Formulario Para Registro Del Cliente (Version Corta)" - North Carolina (Spanish)")
![Form DAAS-543 "Monthly Consumer Contributions/Program Income" - North Carolina](https://data.templateroller.com/pdf_docs_html/2325/23253/2325390/form-daas-543-monthly-consumer-contributions-program-income-north-carolina.png "Form DAAS-543 "Monthly Consumer Contributions/Program Income" - North Carolina")
![Form DAAS-150 "Provider Agency Information" - North Carolina](https://data.templateroller.com/pdf_docs_html/2358/23582/2358233/form-daas-150-provider-agency-information-north-carolina.png "Form DAAS-150 "Provider Agency Information" - North Carolina")
![Form NC-YF-009 "Refrigerated Vaccine Temperature Storage Log - North Carolina Immunization Program" - North Carolina](https://data.templateroller.com/pdf_docs_html/298/2982/298268/form-nc-yf-009-refrigerated-vaccine-temperature-storage-log-north-carolina-immunization-program-north-carolina.png "Form NC-YF-009 "Refrigerated Vaccine Temperature Storage Log - North Carolina Immunization Program" - North Carolina")
![Form DHHS-DAAS-001 "Committee Member Activities Record" - North Carolina](https://data.templateroller.com/pdf_docs_html/2356/23566/2356663/form-dhhs-daas-001-committee-member-activities-record-north-carolina.png "Form DHHS-DAAS-001 "Committee Member Activities Record" - North Carolina")
![Formulario DSS-1432 "Solicitud Para El Programa De Asistencia Nutricional Suplementaria En Caso De Desastre (Dsnap)" - North Carolina (Spanish), 2021](https://data.templateroller.com/pdf_docs_html/2285/22859/2285981/formulario-dss-1432-solicitud-para-el-programa-de-asistencia-nutricional-suplementaria-en-caso-de-desastre-dsnap-north-carolina-spanish.png "Formulario DSS-1432 "Solicitud Para El Programa De Asistencia Nutricional Suplementaria En Caso De Desastre (Dsnap)" - North Carolina (Spanish), 2021")
![Form DHB-5002 "Important Notice About Medicaid or Special Assistance Approval" - North Carolina](https://data.templateroller.com/pdf_docs_html/2426/24268/2426813/form-dhb-5002-important-notice-about-medicaid-or-special-assistance-approval-north-carolina.png "Form DHB-5002 "Important Notice About Medicaid or Special Assistance Approval" - North Carolina")
![Form DHHS/DHSR/EMS4930 "Aed Placement Notification for Ems" - North Carolina](https://data.templateroller.com/pdf_docs_html/2279/22798/2279826/form-dhhs-dhsr-ems4930-aed-placement-notification-for-ems-north-carolina.png "Form DHHS/DHSR/EMS4930 "Aed Placement Notification for Ems" - North Carolina")
![Form DSS5023 "Direct Deposit Enrollment Authorization Form" - North Carolina](https://data.templateroller.com/pdf_docs_html/2427/24279/2427994/form-dss5023-direct-deposit-enrollment-authorization-form-north-carolina.png "Form DSS5023 "Direct Deposit Enrollment Authorization Form" - North Carolina")
![Form DSS-8110 "Notice of Modification, Termination, or Continuation of Public Assistance" - North Carolina](https://data.templateroller.com/pdf_docs_html/2415/24156/2415671/form-dss-8110-notice-of-modification-termination-or-continuation-of-public-assistance-north-carolina.png "Form DSS-8110 "Notice of Modification, Termination, or Continuation of Public Assistance" - North Carolina")
![Form DSS-8207 "Application for Food and Nutrition Services" - North Carolina](https://data.templateroller.com/pdf_docs_html/1881/18819/1881994/form-dss-8207-application-food-and-nutrition-services-north-carolina.png "Form DSS-8207 "Application for Food and Nutrition Services" - North Carolina")
![Form DHHS2089 "Certificate of Absolute Divorce or Annulment" - North Carolina](https://data.templateroller.com/pdf_docs_html/1884/18840/1884010/form-dhhs-2089-certificate-absolute-divorce-or-annulment-north-carolina.png "Form DHHS2089 "Certificate of Absolute Divorce or Annulment" - North Carolina")
![Form DSS-4451 "Application for Services" - North Carolina](https://data.templateroller.com/pdf_docs_html/1881/18819/1881995/form-dss-4451-application-services-north-carolina.png "Form DSS-4451 "Application for Services" - North Carolina")
![Formulario DSS-4451 "Solicitud De Servicios De Sustento De Menores" - North Carolina (Spanish)](https://data.templateroller.com/pdf_docs_html/1881/18819/1881996/form-dss-4451-solicitud-de-servicios-de-sustento-de-menores-north-carolina.png "Formulario DSS-4451 "Solicitud De Servicios De Sustento De Menores" - North Carolina (Spanish)")
![Form DSS-6905 "Work Experience/Community Service Agreement" - North Carolina](https://data.templateroller.com/pdf_docs_html/2427/24279/2427951/form-dss-6905-work-experience-community-service-agreement-north-carolina.png "Form DSS-6905 "Work Experience/Community Service Agreement" - North Carolina")
![Form DHHS1247 "Mycobacteriology (Tb)" - North Carolina](https://data.templateroller.com/pdf_docs_html/1729/17293/1729371/form-dhhs-1247-mycobacteriology-tb-north-carolina.png "Form DHHS1247 "Mycobacteriology (Tb)" - North Carolina")
![Form DSS-8228 "Work First Cash Assistance Application and Review Documentation Workbook" - North Carolina](https://data.templateroller.com/pdf_docs_html/2427/24279/2427952/form-dss-8228-work-first-cash-assistance-application-and-review-documentation-workbook-north-carolina.png "Form DSS-8228 "Work First Cash Assistance Application and Review Documentation Workbook" - North Carolina")
![Form DHHS4108 "Request and Consent for Levonorgestrel Releasing Intrauterine Device" - North Carolina](https://data.templateroller.com/pdf_docs_html/1729/17292/1729242/form-dhhs-4108-request-and-consent-levonorgestrel-releasing-intrauterine-device-north-carolina.png "Form DHHS4108 "Request and Consent for Levonorgestrel Releasing Intrauterine Device" - North Carolina")
![Form DSS-1821 "Nc Kids Family Registration Form" - North Carolina](https://data.templateroller.com/pdf_docs_html/2357/23578/2357821/form-dss-1821-nc-kids-family-registration-form-north-carolina.png "Form DSS-1821 "Nc Kids Family Registration Form" - North Carolina")
![Form DSS-6226 "Nc Division of Vocational Rehabilitation Services and County Social Services Agency/Department Referral" - North Carolina](https://data.templateroller.com/pdf_docs_html/2427/24279/2427972/form-dss-6226-nc-division-of-vocational-rehabilitation-services-and-county-social-services-agency-department-referral-north-carolina.png "Form DSS-6226 "Nc Division of Vocational Rehabilitation Services and County Social Services Agency/Department Referral" - North Carolina")
![Form DSS-8603 "Food and Nutrition Services Returned Disaster Ebt Cards" - North Carolina](https://data.templateroller.com/pdf_docs_html/2285/22859/2285998/form-dss-8603-food-and-nutrition-services-returned-disaster-ebt-cards-north-carolina.png "Form DSS-8603 "Food and Nutrition Services Returned Disaster Ebt Cards" - North Carolina")
![Form DSS-8602 "Food and Nutrition Services Disaster Electronic Benefit Transfer Card Destruction" - North Carolina](https://data.templateroller.com/pdf_docs_html/2314/23143/2314337/form-dss-8602-food-and-nutrition-services-disaster-electronic-benefit-transfer-card-destruction-north-carolina.png "Form DSS-8602 "Food and Nutrition Services Disaster Electronic Benefit Transfer Card Destruction" - North Carolina")
![Form DAAS-8191 "Special Assistance Re-enrollment Information Notice" - North Carolina](https://data.templateroller.com/pdf_docs_html/2415/24156/2415652/form-daas-8191-special-assistance-re-enrollment-information-notice-north-carolina.png "Form DAAS-8191 "Special Assistance Re-enrollment Information Notice" - North Carolina")
![Form DHHS-0004 "Haywood Gymnasium Facility Request Form" - North Carolina](https://data.templateroller.com/pdf_docs_html/2415/24156/2415676/form-dhhs-0004-haywood-gymnasium-facility-request-form-north-carolina.png "Form DHHS-0004 "Haywood Gymnasium Facility Request Form" - North Carolina")
![Form DMA-9052 "Adult Care Home Notice of Transfer/Discharge" - North Carolina](https://data.templateroller.com/pdf_docs_html/412/4124/412483/form-dma-9052-adult-care-home-notice-transfer-discharge-north-carolina.png "Form DMA-9052 "Adult Care Home Notice of Transfer/Discharge" - North Carolina")
![Form DMA-5048 "Medicaid Transportation Exception Verification" - North Carolina](https://data.templateroller.com/pdf_docs_html/273/2738/273841/form-dma-5048-medicaid-transportation-exception-verification-north-carolina.png "Form DMA-5048 "Medicaid Transportation Exception Verification" - North Carolina")
![Form DSS-5169 "Consent of Child for Adoption" - North Carolina](https://data.templateroller.com/pdf_docs_html/235/2354/235424/form-dss-5169-consent-child-adoption-north-carolina.png "Form DSS-5169 "Consent of Child for Adoption" - North Carolina")
![Form DSS-5189 "Consent to Adoption by Parent Who Is Spouse of Stepparent (Stepparent Adoption)" - North Carolina](https://data.templateroller.com/pdf_docs_html/412/4126/412638/form-dss-5189-consent-to-adoption-by-parent-who-is-spouse-stepparent-stepparent-adoption-north-carolina.png "Form DSS-5189 "Consent to Adoption by Parent Who Is Spouse of Stepparent (Stepparent Adoption)" - North Carolina")
![Form DSS-5190 "Consent to Adoption by Parent Who Is Not the Stepparent's Spouse (Stepparent Adoption)" - North Carolina](https://data.templateroller.com/pdf_docs_html/412/4126/412644/form-dss-5190-consent-to-adoption-by-parent-who-is-not-the-stepparent-s-spouse-stepparent-adoption-north-carolina.png "Form DSS-5190 "Consent to Adoption by Parent Who Is Not the Stepparent's Spouse (Stepparent Adoption)" - North Carolina")
![Form DSS-2249 "Affidavit of Adoption Expenditures" - North Carolina](https://data.templateroller.com/pdf_docs_html/2358/23580/2358070/form-dss-2249-affidavit-of-adoption-expenditures-north-carolina.png "Form DSS-2249 "Affidavit of Adoption Expenditures" - North Carolina")
![Form DHHS-0003 "Liability Waiver for Employees, Activities Leaders and Class Coordinators, and State Employees' Spouses and Children 18 Years Old or Older Using the Haywood Gymnasium Facility" - North Carolina](https://data.templateroller.com/pdf_docs_html/2415/24156/2415669/form-dhhs-0003-liability-waiver-for-employees-activities-leaders-and-class-coordinators-and-state-employees-spouses-and-children-18-years-old-or-older-using-the-haywood-gymnasium-facility-north-carolina.png "Form DHHS-0003 "Liability Waiver for Employees, Activities Leaders and Class Coordinators, and State Employees' Spouses and Children 18 Years Old or Older Using the Haywood Gymnasium Facility" - North Carolina")
![Form DHHS-0002 "Liability Waiver for Employees Participating in Fitness Activities Through Work" - North Carolina](https://data.templateroller.com/pdf_docs_html/2415/24156/2415670/form-dhhs-0002-liability-waiver-for-employees-participating-in-fitness-activities-through-work-north-carolina.png "Form DHHS-0002 "Liability Waiver for Employees Participating in Fitness Activities Through Work" - North Carolina")
![Form DSS-1688 "Designation of Authorized Representative" - North Carolina](https://data.templateroller.com/pdf_docs_html/412/4125/412582/form-dss-1688-designation-authorized-representative-north-carolina.png "Form DSS-1688 "Designation of Authorized Representative" - North Carolina")