Register Use this form to register your company for online access to North Carolina New Hire Program Services. *Note: Fields marked with an asterisk indicates required fields. Company Information *Company Name * *Federal Employer Identification NumberNine digits, do not include dashes or spaces * * Password Your password must be at least eight characters long. Your password must utilize at least three of the following four: Special characters Alphabetical characters Numerical characters Combination of upper case and lower case letters * * Password Verification You must retype your exact password in this space * * AddressPlease enter the Employer's primary address Address 2 Address 3 * * City * * State* State [ SELECT ] AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY Other(two-letter abbreviation) * Zip Code Zip Code Extension * - * Country* Country [ SELECT ] AFGHANISTAN ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA AND HERZEGOVINA BOTSWANA BRAZIL BRITISH INDIAN OCEAN TERRITORY BRITISH VIRGIN ISLANDS BRUNEI BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS ISLANDS COLOMBIA COMOROS COOK ISLANDS COSTA RICA CROATIA CUBA CURACAO CYPRUS CZECH REPUBLIC DEMOCRATIC REPUBLIC OF THE CONGO DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC EAST TIMOR ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS FAROE ISLANDS FIJI FINLAND FRANCE FRENCH POLYNESIA GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUAM GUATEMALA GUERNSEY GUINEA GUINEA-BISSAU GUYANA HAITI HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN IRAQ IRELAND ISLE OF MAN ISRAEL ITALY IVORY COAST JAMAICA JAPAN JERSEY JORDAN KAZAKHSTAN KENYA KIRIBATI KUWAIT KYRGYZSTAN LAOS LATVIA LEBANON LESOTHO LIBERIA LIBYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MACEDONIA MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MAURITANIA MAURITIUS MAYOTTE MEXICO MICRONESIA MOLDOVA MONACO MONGOLIA MONTENEGRO MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORTH KOREA NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REPUBLIC OF THE CONGO REUNION ROMANIA RUSSIA RWANDA SAINT BARTHELEMY SAINT HELENA SAINT KITTS AND NEVIS SAINT LUCIA SAINT MARTIN SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SINT MAARTEN SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH KOREA SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWITZERLAND SYRIA TAIWAN TAJIKISTAN TANZANIA THAILAND TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU U.S. VIRGIN ISLANDS UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES URUGUAY UZBEKISTAN VANUATU VATICAN VENEZUELA VIETNAM WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE Is the company less than one year old? Is the company less than one year old? Yes No Offer Medical Insurance? Offer Medical Insurance? Yes No Company's website url Number of Employees Industry Type Industry Type [ SELECT ] Accommodation and Food Services Administration, Business Support and Waste Management Services Agriculture, Forestry, Fishing and Hunting Arts, Entertainment and Recreation Construction Educational Services Finance and Insurance Healthcare & Social Assistance Information Management of Companies and Enterprises Manufacturing Mining, Quarrying, and Oil and Gas Extraction Other Services (except Public Administration) Professional, Scientific and Technical Services Public Administration Real Estate and Rental and Leasing Retail Trade Seasonal Telecommunication Transportation and Warehousing Utilities Wholesale Trade Income Withholding Orders (IWO) Address Yes, use the above Company address for Income Withholding Orders AddressPlease enter the Employer's address used for the processing of Income Withholding Orders Address 2 Address 3 * City * *StateState [ SELECT ] AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY Other(two-letter abbreviation) * Zip Code Zip Code Extension * - * CountryCountry [ SELECT ] AFGHANISTAN ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA AND HERZEGOVINA BOTSWANA BRAZIL BRITISH INDIAN OCEAN TERRITORY BRITISH VIRGIN ISLANDS BRUNEI BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS ISLANDS COLOMBIA COMOROS COOK ISLANDS COSTA RICA CROATIA CUBA CURACAO CYPRUS CZECH REPUBLIC DEMOCRATIC REPUBLIC OF THE CONGO DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC EAST TIMOR ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS FAROE ISLANDS FIJI FINLAND FRANCE FRENCH POLYNESIA GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUAM GUATEMALA GUERNSEY GUINEA GUINEA-BISSAU GUYANA HAITI HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN IRAQ IRELAND ISLE OF MAN ISRAEL ITALY IVORY COAST JAMAICA JAPAN JERSEY JORDAN KAZAKHSTAN KENYA KIRIBATI KUWAIT KYRGYZSTAN LAOS LATVIA LEBANON LESOTHO LIBERIA LIBYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MACEDONIA MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MAURITANIA MAURITIUS MAYOTTE MEXICO MICRONESIA MOLDOVA MONACO MONGOLIA MONTENEGRO MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORTH KOREA NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REPUBLIC OF THE CONGO REUNION ROMANIA RUSSIA RWANDA SAINT BARTHELEMY SAINT HELENA SAINT KITTS AND NEVIS SAINT LUCIA SAINT MARTIN SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SINT MAARTEN SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH KOREA SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWITZERLAND SYRIA TAIWAN TAJIKISTAN TANZANIA THAILAND TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU U.S. VIRGIN ISLANDS UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES URUGUAY UZBEKISTAN VANUATU VATICAN VENEZUELA VIETNAM WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE Payroll Provider If you are a PAYROLL PROVIDER (or Service Bureau) registering YOUR OWN ACCOUNT (through which you will report for other employers), use this form, and be sure to click the Payroll Provider check box below. If you are NOT A PAYROLL PROVIDER and WILL NOT REPORT FOR OTHER EMPLOYERS, use this form, and do not click the Payroll Provider check box below. Payroll Provider Yes Contact Information * First Name: First name must be at least two characters long * * Last Name: Last name must be at least two characters long * Contact Title * Phone: Phone number must be ten digits * Fax: Fax number should include leading zero followed by area code * Email * Contact Preference Select your Contact Preference Email Fax Phone Mail Reporting Preference Select your Reporting Preference Online - Interactive Online - Upload FTP (File Transfer) Fax Mail
