North Carolina Forms
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| Document Name | Summary | Tags |
|---|---|---|
| 2023 NC Independent Living Payroll Payment Schedule | 2023 North Carolina Payroll Payment Schedule. This iLIFE document details the pay period start dates, end dates, due dates, and check date | Attendant |
| 2024 NC Independent Living Payroll Payment Schedule | 2024 North Carolina Payroll Payment Schedule. This iLIFE document details the pay period start dates, end dates, due dates, and check date | Attendant |
| 2024 Attendant Start-Up Packet (Sample) | This packet includes all of the forms an Attendant may need to complete to be a service provider with iLIFE. | Attendant |
| Attendant Information Form (fillable) (Sample) | The Attendant Information Form is used to verify the Attendant's and Consumer's information. | Attendant |
| Form W-4 (Sample) | This is a sample form of the W-4. Form W-4 is used to withhold the correct amount of Federal income tax from your pay. | Attendant |
| Form NC-4 EZ (fillable) (Sample) | Employee’s Withholding Allowance Certificate | Attendant |
| Copies of Social Security Card and Form I-9 Documents | Used to verify the Attendant’s identity and employment status. | Attendant |
| Form I-9 | This is a sample form of the I-9. Form I-9 is used to document verification of the identity and employment authorization of the Attendant. | Attendant |
| Employer and Attendant Agreement (fillable) | Employer and Attendant Agreement. This form is to verify that the Consumer and the Attendant agree on employment guidelines. | Attendant |
| InCheck OOS General Forms Packet | This is the Background Check Disclosure and Release form. This form is used to verify identity of Attendant for employment. | Attendant |
| Relationship Disclosure (fillable) (Sample) | Relationship Disclosure Form. This form is to idenfity if the Attendant and the Consumer have a legal relationship with each other. | Attendant |
| iLIFE and Attendant Employment Agreement | iLIFE and Attendant Employee Agreement. This form is to verify that iLIFE and the Attendant agree on employment guidelines. | Attendant |
| Direct Deposit Authorization (fillable) (Sample) | Direct Deposit Authorization. This form is to list direct deposit information for payment. | Attendant |
| Attendant Status Change Form (fillable) (Sample) | Attendant Status Change Form. This form is used to indicate if an Attendant's work status was changed. | Attendant |
| Attendant Timesheet (Sample) | Attendant Timesheet. This form is used to indicate what days and times the Attendant worked. | Attendant |
| Attendant Start Date Letter (Attendant Copy) | Attendant Start Date letter. This letter informs the Attendant that the application process for employment is complete. It lists the date that they can begin work. | Attendant |
| Grievance Form. This form is used for any ILDVR iLIFE program consumers and/or Attendants to file any formal grievances regarding any experience that they may have had in the ILDVF program. | Attendant | |
| NC IL Local Office FAQ | Frequently asked questions for NC IL | |
| 2024 Consumer Start-Up Packet (Sample) | Consumer Sample Form Packet. This packet includes all of the documents that need to be completed for employment at iLIFE. | Consumer |
| Consumer Information Form (fillable) (Sample) | Sample of the Consumer Information Form. This form to verify consumer information. | Consumer |
| Form 2678 (Sample) | Form 2678. This form is to request approval to have an agent file returns and make deposits or payments of employment or other withholding taxes. | Consumer |
| Form SS-4 (Sample) | Form SS-4. This form is used to apply for an Employer Identification Number. | Consumer |
| Form 8821 (Sample) | Form 8821. This form authorizes the IRS to disclose your confidential tax information to your employer. | Consumer |
| Form NCUI 604 – Employer Status Report (Sample) | Form NCUI 604 is used to determine liability under the North Carolina Employment SecurityLaw, General Statute 96 and division regulations. | Consumer |
| Form GEN-58 (Sample) | Form GEN-58. This form is used to appoint someone else to handle tax affairs before the Department of Revenue. | Consumer |
| iLIFE and ILDVR Consumer Agreement (fillable) | iLIFE and ILDVR Consumer Agreement. This form is to acknowledge and agree to the rules of working with iLIFE. | Consumer |
| iLIFE Consent for the Release of Confidential Information (fillable) | iLIFE Consent for the Release of Confidential Information. | Consumer |
| Consumer Status Change Form (fillable) (Sample) | This form is for changing the status of a Consumer. | Consumer |
| Change of Policy - Attendant Start Date Notification Letter | Change of Policy Letter. This letter is to inform the Attendant of any changes to the North Carolina policy. | Consumer |
| Attendant Start Date Letter (Consumer Copy) | Attendant Start Date Letter. This letter informs the Attendant that the application for employment is complete. It lists the date that they can begin work. | Consumer |
| Consumer Employer Handbook | Consumer Employer Handbook. This form lists tips on how to be a successful employer for your Attendants. | Consumer |
| OSHA Standard Precautions for your Attendant | OSHA Standard Precautions for Your Attendant. This form has guidelines on preventing the spread of blood borne diseases and infections. | Consumer |
| Standard Precautions for Bloodborne Transmission | Standard Precautions for Blood-borne Transmission. This form has guidelines on practicing basic infection control against blood-borne diseases. | Consumer |
| Grievance Form for North Carolina Independent Living Program | Grievance Form. This form is used for any ILDVR iLIFE program consumers and/or Attendants to file any formal grievances regarding any experience that they may have had in the ILDVR program. | Consumer |
| Case Manager Contact Form (fillable) | Case Manager Contact Form. This form is to list the contact information for the Case Manager. | Case Manager |