"Placement Contract Check-Off List" - North Carolina

Placement Contract Check-Off List is a legal document that was released by the North Carolina Department of Labor - a government authority operating within North Carolina.

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Wage & Hour Bureau
1101 Mail Service Center
Raleigh, NC 27699-1101
PLACEMENT CONTRACT CHECK-OFF LIST
1
1. A contract between a private personnel service and an applicant shall be in writing, labeled as a
contract, physically separate from any application and made in duplicate. One copy shall be given
to the applicant and the other shall be kept by the private personnel service as required by G.S. §
95-47.5(2).
1 2. Name, address, and telephone number of the private personnel service.
1 3. Name of applicant.
1 4. Date the contract was signed.
1 5. Clear schedule of the fees to be charged to the applicant at various salary levels.
1 6. A clear explanation of when the applicant becomes obligated to pay a fee. If compensation is
based, in whole or in part, on commissions, a description of how the private personnel service
determines its fee.
1 7. A clear refund policy that conforms to §95-47.4(f) or no refund policy with the following statement,
“XYZ Personnel Service will make NO REFUND under any circumstances of fees paid by the
applicant.” The words “NO REFUND” and no other shall be in all capitals.
1 8. If there is a refund policy, statement defining the following must be included: (a) the length of the
period of time covered by the refund policy; (b) the exact manner of computing the refund so that
the amount of refund due the applicant will be clear; (c) the conditions under which a refund
becomes due to the applicant; (d) if other than unconditional policy is used, a definition of the
reasons for which a refund will not be made.
1 9. Statement in type size no smaller than nine point, directly above the place for the applicant’s
signature, that reads as follows: “I have read and received a copy of this CONTRACT”, which I
understand makes me legally obligated to pay a fee under conditions outlined above.” The word
“CONTRACT” and no others shall be in all capitals.
1 10. A statement that the private personnel service does not guarantee that the applicant will obtain
employment as a result of its services.
1 11. A statement that the private personnel service is licensed and regulated by the Commissioner of
Labor and the address at which a copy of the laws and regulations may be obtained.
1 12. Place for signature of the applicant and representative of the private personnel service. Adjacent
to applicant’s signature, the applicant’s name shall be typed or printed.
CAUTION: Do not have contracts printed until the Wage and Hour Bureau has approved them.
Wage & Hour Bureau
1101 Mail Service Center
Raleigh, NC 27699-1101
PLACEMENT CONTRACT CHECK-OFF LIST
1
1. A contract between a private personnel service and an applicant shall be in writing, labeled as a
contract, physically separate from any application and made in duplicate. One copy shall be given
to the applicant and the other shall be kept by the private personnel service as required by G.S. §
95-47.5(2).
1 2. Name, address, and telephone number of the private personnel service.
1 3. Name of applicant.
1 4. Date the contract was signed.
1 5. Clear schedule of the fees to be charged to the applicant at various salary levels.
1 6. A clear explanation of when the applicant becomes obligated to pay a fee. If compensation is
based, in whole or in part, on commissions, a description of how the private personnel service
determines its fee.
1 7. A clear refund policy that conforms to §95-47.4(f) or no refund policy with the following statement,
“XYZ Personnel Service will make NO REFUND under any circumstances of fees paid by the
applicant.” The words “NO REFUND” and no other shall be in all capitals.
1 8. If there is a refund policy, statement defining the following must be included: (a) the length of the
period of time covered by the refund policy; (b) the exact manner of computing the refund so that
the amount of refund due the applicant will be clear; (c) the conditions under which a refund
becomes due to the applicant; (d) if other than unconditional policy is used, a definition of the
reasons for which a refund will not be made.
1 9. Statement in type size no smaller than nine point, directly above the place for the applicant’s
signature, that reads as follows: “I have read and received a copy of this CONTRACT”, which I
understand makes me legally obligated to pay a fee under conditions outlined above.” The word
“CONTRACT” and no others shall be in all capitals.
1 10. A statement that the private personnel service does not guarantee that the applicant will obtain
employment as a result of its services.
1 11. A statement that the private personnel service is licensed and regulated by the Commissioner of
Labor and the address at which a copy of the laws and regulations may be obtained.
1 12. Place for signature of the applicant and representative of the private personnel service. Adjacent
to applicant’s signature, the applicant’s name shall be typed or printed.
CAUTION: Do not have contracts printed until the Wage and Hour Bureau has approved them.