Forms

participation form

This important document lists important information such as your contact information that is used for our Interactive Voice Response (IVR) system that informs debtors who to contact at your site for information regarding debts you are submitting to the Clearinghouse.

This form is required to begin participating and each year after. The form covers the period of September through the following December. The next year's participation form becomes available just prior to the annual training workshops which occur in September. This allows for the submission of debts at the end of a calendar year and continue for the entire next year. Note: if a local government does not submit this form by late December, their debts will not be sent to the Department of Revenue and Education Lottery until the form is submitted.

For the September 2016 through December 2017 form: 2017 Participation Form Trouble printing or just want to complete a hard copy form, click here for a pdf version. Please complete the online form even if problems printing.

After submitting, anytime during the year if there are any changes to contacts, emails or phone numbers, then re-submit the online form with just the changes, no need to sign and mail.

initial sign-up forms

All of these forms need to be sent to North Carolina League of Municipalities (cities and towns) or North Carolina Association of County Commissioners (counties and all others).

other forms and documents

Sample Notification Letters to Debtors

According to the Statute, notification letters must be detailed and describe each debt. The type of debt (or department), description of the debt, account number and amount of the debt is required. The five samples below are the format of the letters in the client software.

Data Submission Options (4)