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 * Zip Code Zip Code Extension * - 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 * Zip Code Zip Code Extension * - 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
