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NC Dept of Public Safety logo   North Carolina Department of Public Safety
 

 Personnel Office

Photo of Shore Building, Raleigh NC - Home of DOC personnel office

Please See the
DPS Human Resources
page for the latest personnel information and forms

This page and most of these forms are
Out Of Date

As we are made aware of information and forms being available on the DPS web site,
they will be de-linked on this page. Please note this page is not being actively maintained.


Benefits
Community Service Leave Dental Insurance  Voluntary Shared Leave
Disability Other Insurance Worker's Comp/Salary Continuation
Family Medical Leave Memorial Program 401K / Deferred Comp
NCFlex Benefits Retirement  
State Health Plan Insurance Options Military Leave 
Insurance Forms and Job Aids Family Illness Leave  
Classification & Salary Administration
Career Banding:  Class Specs, Competency Profiles, & Posting Ranges  Forms: Other:
Engineering MS Word icon Education & Work History Worksheet      2014 Salary Grade Schedule 
Fiscal PDF icon Clerical Job Description Form   2014 Career Banding Salary Schedule  
Information Technology PDF icon Job Description Form    2014 Medical Salary Schedule  
Library PDF icon Job Description Instructions Salary Plan Book  
(Revised 07/13)
Nursing MS Word icon Education & Work History Worksheet
Pharmacy MS Word icon Clerical Job Description Form  
Career Banding:  Forms & Information  MS Word icon Job Description Form  
MS Word icon Career Banding Competency Assessment Form MS Word icon Career Banded Job Description Form  
 Instructions for Completing the Competency Assessment Form MS Word icon Position Action Form    (Revised 06/03/10)  
MS Word icon Career Banded Job Description Form MS Word icon Position Action Change Form    (Revised 06/03/10)
Career Banding Salary Administration Plan MS Word icon On-Call Request Form    
Career Banding Posting Summary    
Career Banding Posting Procedures    
Promotional Priority Policy Changes    
Career Banding Changes & Definitions    
Policy
Personnel Policy Manual: Administrative Memos: Other:
Personnel Policy Manual 2000 Administrative Memos 2014 Holiday Schedule
Policy Revision Memos 2001 Administrative Memos 2015 Holiday Schedule
2002 Administrative Memos 2016 Holiday Schedule
2003 Administrative Memos 2017 Holiday Schedule
2004 Administrative Memos  
  2005 Administrative Memos  
  2006 Administrative Memos  
  2007 Administrative Memos  
  2008 Administrative Memos  
  2009 Administrative Memos  
  2010 Administrative Memos  
  2011 Administrative Memos  
Training / TAP / Employee Relations
HR Training: Performance Management (TAP): Employee Relations: Mediation 
Staff Contact Information TAP Forms Staff Contact Information For information on filing an appeal for TAP, Disciplinary Actions, & Administrative Grievances, select below:
Training Course Catalog

TAP Performance Standards

    Step (1) Appeal - Mediation

TAP Performance Cycles
(Performance discussions due-date cheat sheet)

  Step (2) Appeal

General TAP Info
(Handout for New Employees during the Work Plan Discussion)

   
TAP Dispute Resolution
(click here for information on filing a TAP Dispute)
   
Operations
PDF icon List of Criminal Justice Certified Positions (03/08/11)  **Please refer to the "Certified New Hire Checklist" when compiling new hire packages for classifications found on this list.  For classifications that are NOT on this list, please refer to the "Non-Certified New Hire Checklist" when compiling new hire packages.**

New Hire Checklists:  New graphic
PDF icon Certified New Hire Checklist (12/11)- Contains a list of forms/documents required for a new hire certified package.
PDF icon Non-Certified New Hire Checklist (12/11) - Contains a list of forms/documents required for a new hire non-certified package. 
 
Forms:  
 MS Word icon Request to Hire Form  New graphic PDF icon TitleVII:  Interview Team Summary Form (required for DOP Title VII classes)
MS Word icon Vacancy Posting Announcement  New graphic PDF icon Form F-5A:  Application for Certification
MS Word icon Applicant Interview Record Form PDF icon Form F-5C:  Reinstatement of Certification
MS Word icon Conditional Offer PDF icon Form F-5D:  Notice of Transfer
MS Word icon DC-154: Personnel Action Report (Rev 10/11)  New graphic PDF icon Form F-1:  Medical History Statement
MS Word icon DC-154-Banded    (Rev 10/11)  New graphic PDF icon Form F-2:  Medical Examination Report
MS Word icon DC-730VS: Applicant Verification Stmt PDF icon Request for Probationary Certification Extension
MS Word icon DC-154S:  Permanent Separation         PDF icon Request for Secondary Employment Form
MS Word icon DC-154L:  Leave of Absence         PDF icon Foreign National Info System Data Form
MS Word icon Leave of Absence Request Form       PDF icon   Leave of Absence Guide    New graphic PDF icon Form I-9:  Employment Eligibility Form  (Revised 08-09)     Instructions for Form I-9
MS Word icon AA-100:  Applicant Recruitment Report PDF icon Employee Statement:  Criminal Conviction(s) that Subjects an Individual to Firearms Prohibitions
MS Word icon Prior Service Form PDF icon Processing Guidelines for NC Felony Firearms Act Gun Ban
MS Word icon Employment Statements Form  
MS Word icon RIF Verification Form  (Rev 10/11)  New graphic  
MS Word icon RIF Explanation Form  (Rev 10/11)  New graphic  
MS Word icon Degree Verification Form  
MS Word icon Notification Form for Criminal Offenses  
MS Word icon Personal Data Change Form   
MS Word icon DC-700 Delayed Salary Increase Request Form   
MS Word icon Temporary/Reup Request Form (Revised 10-09)  
MS Word icon Retiree Temporary Employment Statement  

Direct Deposit Forms

Direct Deposit Enrollment & Change Form
MS Word icon Direct Deposit Exemption Request Form
MS Word icon Mandatory Direct Deposit Notification (for New Hires)
 


Posters :

PDF icon Right To Work - English
PDF icon E-Verify Employer - English  New graphic
PDF icon Right To Work - Spanish
PDF icon E-Verify Employer - Spanish New graphic
PDF icon Federal Minimum Wage Poster - (also visit www.dol.gov/esa/whd/regs/compliance/posters/flsa.htm )

 

State & Federal Tax Withholding Forms

PDF icon NC-4 State Tax Withholding Form
PDF icon W-4 Federal Tax Withholding Form
 
 

 

Americans with Disabilities (ADA) Forms
ADA Forms ADA Letters In-Service
MS Word icon DC-730:  Request for Accommodation MS Word icon Letter #1:  Initial letter to physician requesting medical information MS Word icon In-Service Essential Job Functions (CPR)
PDF icon DC-730-T:  Request for Accommodation (Basic Training Only) MS Word icon Letter #2:  First follow-up letter to physician MS Word icon In-Service Essential Job Functions (Batons, Restraints, CRDT)
MS Word icon Form provided to employee acknowledging receipt of the DC-730 MS Word icon Letter #3  Letter to employee when first follow-up letter mailed to physician MS Word icon In-Service Essential Job Functions (Firearms - DOP)
MS Word icon Info about ADA - Provided to employee upon receipt of DC-730 MS Word icon Letter #4  Second follow-up letter to physician MS Word icon In-Service Essential Job Functions (Firearms - DCC)
MS Word icon ADA Coordinator's Log MS Word icon Letter #5  Letter to physician requesting additional information  
MS Word icon ADA Regional Coordinator's Checklist MS Word icon Letter #6  Letter to employee requesting an updated application  
DOC Jobs
DAC Vacancy List Applying for a State Job FAQ Potential Disqualifiers for Employment
State Job Opportunities Search North Carolina Online Job Application System State Application Form (PD-107)           (also in word format)
Department of Correction Personnel
214 West Jones St , 4203 MSC
Raleigh, NC  27699-4203
Phone   (919)716-3700 
Fax (919)716-3955

 

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THE NORTH CAROLINA DEPARTMENT OF CORRECTION DOES NOT DISCRIMINATE ON THE BASIS 
OF RACE, COLOR, SEX, RELIGION, NATIONAL ORIGIN, AGE, OR DISABILITY.

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