NCDOL Forms | North Carolina Department of Labor Intranet

Financial Services Division

Account Receivables
Form Title	Document Revision Date
File OSH Write Off Submission Form	June 14, 2023 - 12:00pm
File Payment Submission Form
File Standards and Inspections Write Off Submission Form

Purchasing Forms
Form Title	Document Revision Date
File Prescription Safety Glass Form
File Safety Glasses - Frames and Providers

Travel
Form Title	Document Revision Date
File Blanket Travel Authorization Form	June 17, 2025 - 12:00pm
File NCDOL Travel Advance Form	October 1, 2025 - 12:00pm
File Employee Waiver for use of Personal Vehicle for NCDOL Business	January 8, 2025 - 12:00pm
File DOL B8 Pre-Travel Authorization Form	October 1, 2025 - 12:00pm
File Travel Reimbursement Request Form	October 1, 2025 - 12:00pm

Human Resources

Form Title	Document Revision Date
File pre-employment-drug-test-consent-form-2025.doc

NCDOL Policies
Form Title	Document Revision Date
File DOL Informal Grievance Filing Form	March 27, 2025 - 12:00pm
File Telework Policy	July 2, 2025 - 12:00pm
File Form 101 - Personnel Action Recommendation	April 10, 2025 - 12:00pm
File Form 101 AB - Hiring Addendum	June 23, 2025 - 12:00pm
File Form 101AB Continued	June 16, 2025 - 12:00pm
File Form 101C - Applicant Release Form	June 16, 2025 - 12:00pm
File Form 102 - Employee Information Change Form	March 1, 2025 - 12:00pm
File Form 103 - Reference Check Form	June 16, 2025 - 12:00pm
File Form 104 - Manager's Checklist for New Employees	August 11, 2025 - 12:00pm
File Form 105 - Request for Voluntary Shared Leave	June 16, 2025 - 12:00pm
File Form 106 - Supervisor's Record of Time Taken under FMLA	January 19, 2010 - 12:00pm
File Form 107 - Voluntary Shared Leave Donation	January 5, 2011 - 12:00pm
File Form 108-1 - Employee Grievance (Step 1) Filing Form	June 18, 2025 - 12:00pm
File Form 108-2 - Employee Grievance (Step 2) Appeal Notice	March 27, 2025 - 12:00pm
File Form 109 -Request For Advertising Job Vacancy	July 16, 2025 - 12:00pm
File Form 111 - Request for Reasonable Accommodation	March 1, 2025 - 12:00pm
File Form 114 - Supervisor's Separation Checklist	June 25, 2025 - 12:00pm
File Form 117 - Temporary Employment Request	July 2, 2025 - 12:00pm
File Form 119 - Secondary Employment Request Form
File Form 123 - Confidential Employee Emergency Contacts	February 4, 2015 - 12:00pm
File Form 127 - Request for FMLA	January 20, 2010 - 12:00pm
File Inventory Authorization to Withhold Wages	June 16, 2025 - 12:00pm
File NCDOL Social Media Policy	October 1, 2013 - 12:00pm

File Work at Home Form
File Safe Days Certification Form	December 3, 2019 - 12:00pm

File 01. Employee Incident Report	September 1, 2023 - 12:00pm
File 02. Injury Data collection form for Supervisors	January 1, 2020 - 12:00pm
File 03. Workers' Compensation Refusal of Treatment

Legal Affairs

Form Title	Document Revision Date
File Driver Record Release Form	January 11, 2021 - 12:00pm
File Third Party Litigation Form

NCDOL

NCDOL Policies
Form Title	Document Revision Date
File form-101-par.docx
File New Hire / Separation Form	July 1, 2023 - 12:00pm

OSH Compliance

Account Receivables
Form Title	Document Revision Date
File OSH Write Off Submission Form	June 14, 2023 - 12:00pm

Ergonomics
Form Title	Document Revision Date
File Ergonomics Evaluation Assessment Tool

Occupational Health
Form Title	Document Revision Date
File Health Recommendation Form
File OSH Monthly Time Distribution Report

Publications

Form Title	Document Revision Date
File Print Requisition Form for Publications	July 2, 2025 - 12:00pm

Research and Information Technology

Form Title	Document Revision Date
File Acceptable Use Policy	September 1, 2024 - 12:00pm

Steering Unit

Purchase Specifications
Form Title	Document Revision Date
File Minimum Purchase Specifications

Unit Inspection Form
Form Title	Document Revision Date
File Fire Safety Equipment Inspection Report	March 6, 2012 - 12:00pm
File Safety and Health Unit Inspection Form