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1. Local Government Name
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2a. Type
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City/Town
County or County Department
Water & Sewer Auth. (Ch. 162A Art. 1)
Joint Regional Agency (Ch. 160A Art. 20)
Public Health Authority (Ch. 130A Art. 2)
Metro. Sewerage Dist. (Ch. 162A Art. 5)
Sanitary District (Ch. 130A Art. 2)
Housing Authority (Ch. 157)
Regional Solid Waste Management Authority (Ch. 153A Art. 22)
Vendor/Third-party administrator
Other
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2a. If Other, please specify
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3. What is the status of your Local Government with the Debt Setoff Clearinghouse?
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Active (currently submitting debts)
Inactive (submitted forms but not debts)
New (no forms or debts submitted)
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4. Have you ever attended a Debt Setoff Clearinghouse Workshop?
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Yes
No
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5. Location (all sessions 9:30 a.m. - 12:00 p.m.)
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a) Waynesville - Tue., Oct. 15, 2024 - Town of Waynesville - CANCELLED
b) Newton - Wed., Oct. 16, 2024 - Catawba County Emergency Operations Center, 100 Government Drive, Newton 28658
c) Asheboro - Thur., Oct. 17, 2024 - Randolph County Office Building, 725 McDowell Rd, Meeting Room B, Asheboro 27205
d) Washington - Tue., Oct. 29, 2024 - Beaufort County Community College, Bldg. 8, 5337 Hwy 264 East, Washington 27889
e) Wilmington - Wed., Oct. 30, 2024 - New Hanover County Main Library Administration, New Hanover Room (enter through the staff entrance on the 3rd floor), 201 Chestnut Street, Wilmington 28401
f) Raleigh - Thur., Oct. 31, 2024 - North Carolina Medical Society, NCMS Auditorium, 222 North Person Street, Raleigh 27601
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6) Are there any topics or issues you would like covered?
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7a. Name
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7b. Email Address
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7c. Department
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7d. Job Title or Description
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7e. Phone Number
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8a. Name of Attendee #2
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8b. Email Address of Attendee #2
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8c. Department of Attendee #2
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8d. Job Title or Description of Attendee #2
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9a. Name of Attendee #3
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9b. Email Address of Attendee #3
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9c. Department of Attendee #3
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9d. Job Title or Description of Attendee #3
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10a. Name of Attendee #4
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10b. Email of Attendee #4
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10c. Department of Attendee #4
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10d. Job Title or Description of Attendee #4
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11a. Name of Attendee #5
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11b. Email of Attendee #5
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11c. Department of Attendee #5
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11d. Job Title or Description of Attendee #5
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