Forms and Documents

General Business Forms

General Business Forms

ACH Handbook – This booklet contains general information about Electronic Funds Transfer (EFT) as well as instructions for making EFT payments using National Automated Clearing House Association (NACHA) rules and regulations through the Automated Clearing House (ACH) Credit method.

Job Listing Fax Forms - Waste no time displaying your job openings. Fax your job orders directly to the Division of Employment Security.

NCESC 524 – Certificate of Coverage and Notice to Workers as to Benefit Rights (English).

NCESC 524 – Aviso a los Trabajadores acerca de los Derechos de Beneficios y Certificado de Cobertura (Spanish).

NCUI 101 – A fast and efficient way for employers to submit reports.

NCUI 101B  –  Continuation Sheet for Report of Employee Wages.

NCUI 101A – Change in Status Report. Used to notify the Division when changes in status occur such as changes in ownership, changes of address, when the business closes or ceases to operate, or when a closed or inactive business begins to operate again.

NCUI 604 – Employer Status Report.

NCUI 685 – Adjustment to Employer's Quarterly Tax & Wage Report. This form is used to correct errors made on previously submitted quarterly tax and wage reports.

Notice of Attorney Supervision Form – Allows an individual under the supervision of an attorney licensed to practice law in the State of North Carolina to represent employers in hearings and to enter appeals.

Quarterly Tax and Wage Reporting – Specifications and Record Layouts for Magnetic and Electronic Filing.

Quarterly Tax Payment Voucher – If you file your quarterly tax and wage report online and intend to pay by check or money order, download and complete this form. Attach your payment to the completed form and mail them to DES to ensure proper credit to your account.

RC-1 – Employer's Election to Cover Multi-State Workers Under the Employment Security Law of North Carolina.

Remitter Authorization Form – Authorization form to allow a remitter to be linked to an employer account.

Reporting of New Hires

Specifications for Automated Account Number Verification Program – DES can match an Employer’s Federal Identification Number (FEIN) to a North Carolina reporting number.

Specifications for the Automated Tax Rate Reporting Program – The tax rate reporting program can be run at any time during a calendar year to report the current year tax rates.

Business Posters

Business Posters

Certificate of Coverage and Notice to Workers as to Benefit Rights

Employers determined to be liable under the Employment Security Law (Chapter 96 of the North Carolina General Statutes) are required to prominently display the Certificate of Coverage and Notice to Workers poster in their workplace.

NCDES 524, Certificate of Coverage for and Notice to Workers (English)
NCDES 524S, Certificado de cobertura y aviso para trabajadores sobre (Spanish)

Power of Attorney Forms

Power of Attorney Forms

Power of Attorney - Power of Attorney and Declaration of Representative Form

Allows the representative to file Employer's Quarterly Tax and Wage Reports, to file benefit information and to generally authorize the reporting agent to do those things that the employer may do concerning the employer's tax and claims records with DES.

Power of Attorney Instruction Document - Detailed explanation regarding types of Power of Attorney

Forms for Disaster Unemployment Assistance (DUA)

Forms for Disaster Unemployment Assistance (DUA)

Employer Helpful Hints for Disaster Unemployment Assistance.

Understanding Disaster Unemployment Assistance (DUA) in North Carolina.

General Forms for Individuals

General Forms for Individuals

NCUI 506E – Work Search Record

The Employment Security Law, G.S. 96-14.9(e), requires you to be registered for work ( and actively seeking work for each week claimed for unemployment insurance benefits. You must make a minimum of three contacts with potential employers for each week claimed.

NCUI IB10-A – Eligibility Review Notice and Work Search Record for Interstate (Out-of-State) Claimants.

NCUI 500TW – Voluntary Election for Withholding of Individual Income Tax and or Direct Deposit of UI Benefits

Unemployment Insurance benefits are taxable for both Federal and State government. You may elect to have the Employment Security Commission withhold a portion of your benefits each week to meet this tax obligation. You may also elect to have your benefit check directly deposited into your bank account instead of being delivered by the US mail. To request either of these options, sign in to your claimant portal.

NCUI 500TWC - To change tax withholding or direct deposit information you can utilize Form NCUI500TWC.

NCUI 517x – Information about Unemployment Insurance for Workers on Temporary Layoff

Your employer will notify you when a temporary layoff occurs or is pending, and will also inform you of the time and place where you will be required to furnish information for unemployment insurance benefits. Your employer is required to give you this form if you become temporarily unemployed.

Pamphlets for Individuals

Pamphlets for Individuals

Benefit Rights - The following information is a summary of the legal requirements and your rights and responsibilities while filing a claim for unemployment insurance benefits. Read all of this information carefully and refer to it as needed.