Macon County • Human Resources
Form Downloads

LIFE Program Physical Activity Log
• WAIVER for Physical Activity
• Instructions for Physical Activity Log 2015/16
• LIFE Program Physical Activity Log 2015 - 2016
• LIFE Program - Activities July 1, 2015-June 30, 2016
• LIFE Program - Brief Description
• LIFE Program Leave Request Form 2015-2016
• LIFE Program - Participant Guidelines(Rules) 2015- 2016

NC Retirement System
• NC Local Government Employees' Retirement Handbook
• NC Law Enforcement Officers Retirement Handbook for Sworn Officers
• Form 2DB-Designating Beneficiary for Death Benefit
• Form 2RC-Designating Beneficiary for Retirement System Return of Contributions
• Form 5-Withdrawing Your Retirement
• Form 6-Claiming Your Monthly Retirement Benefit
• Form 45-Purchasing Retirement Credit for Part-Time Employment
• Form 170-Authorizing Direct Deposit
• Form 443-Purchasing Retirement Credit for Temp Employment
• Form ESSR-Certifying Employee Status under Reemployment Laws(NC Retirement System)
• Updating Your Addresses or Name(Not for Regularly Employed and Contributing Members)

NC401-K Prudential
• NC401K Enrollment Form
• NC401K Beneficiary Designation Form
• NC401K Contribution GoalMaker and/or Allocation Change Form
• NC401K Request for Name and/or Address Change
• NC401K Instructions for Service Credit Purchase
• NC401K Report of Termination-Request for Disbursement
• NC401K Rollover PreApproval
• NC401K Request for Systematic Disbursement
• NC401K Request for Minimum Required Distribution
• NC401K Notification of Termination
• NC401K Special Tax Notice Regarding Plan Payments
• NC401K One Time Contribution Form
• NC401K Change of Employer
• NC401K Instructions for Requesting a Hardship Withdrawal

Accident, Injury and Worker's Comp
• Employee's Version of Accident for WC Claim
• Employer's Report of Injury to Industrial Comission
• Supervisor's Accident Investigation Report
• Notification of Return to Work from Worker's Comp
• Non-Employee Accident Report
• Injury Waiver of Medical Attention & Treatment
• Reporting Procedures for Workers Comp Claims & FAQ
• Workers Compensation Prescription Form
• Accident Report Form / Drug Test Form
• Property and Liability Claim Form

Colonial
• Colonial - Request for Service-Address Changes
• Colonial - Emp term but want to keep insurance

Community Eye Care - Vision
• Community Eyecare Enrollment, Change, Termination

Employment Forms
• Macon County Emergency Contact Information
• Background Check
• Overtime Request
• Medical Release to Return to Work
• Payroll Change Authorization
• Personnel Action Form
• New Employee Certification
• Emp. Exit Interview
• Direct Deposit
• I-9 Employment Eligibility Verification
• Part-Time Name Address Phone Change
• Written Warning

Travel
• Travel Request and Authorization
• Travel Reimbursement

Covid - 19 Forms
• Emergency Paid Sick Leave Request Form

Family Medical Leave
• Employees' Guide to FMLA
• Employees' Instructions for FMLA
• Fact Sheet #28: The Family and Medical Leave Act
• Certification of Health Care Provider Family Member's Serious Health Condition
• Certification of Health Care Provider Employee's Serious Health Condition
• DOL Notice Eligibility Rights Responsibilities
• Request for Leave and Notification
• Medical Release to Return to Work
• Notification of Return to Work from FMLA
• Military Family Leave Entitlements

Voluntary Shared Leave
• Employee Shared Leave Policy
• Request for Voluntary Shared Leave
• Donation Form for Voluntary Shared Leave

Prudential 457B
• Enrollment Form
• Instructions For Choosing Your Beneficiary
• Contribution, GoalMaker and/or Allocation Change Form
• Request for Name and/or Address Change
• Service Credit Purchase
• Termination Distribution
• Instructions for Rollover Pre-Approval
• Request for Systemactic Disbursements
• Required Minimum Distribution Request
• Notification of Termination
• Special Tax Notice Regarding Plan Payments
• Combo One Time Contrib Form
• Employer Change
• Voluntary Inservice Disbursement
• Request for Unforeseen Emergency

USAble Life Insurance
• Beneficiary Change / Update Form
• Macon County Group Certificate - Active Full Time Employees - 20K & Above
• Macon County Group Certificate - Active Full Time Employees - 15K > 20K
• Macon County Group Certificate - Active Full Time Employees - 10K > 15K
• Macon County Group Certificate - Active Full Time Employees - < 10K
• Macon County Group Certificate - Active Full Time County Commissioners

Health & Dental Insurance
• BCBS Change Form
• Health Claim Form
• Macon County Enrollment Form
• Macon County Change Report Form
• Macon County Emergency Contact Information - NEW

LWOP
• Request for Leave Without Pay
• Notification of Return to Work from LWOP

Tax Forms
• NEW W-4 2021 Federal Withholding
• NC Employee's Withholding Allowance Certificate
• NC-4EZ Employee's Withholding Allowance Certificate