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Forms - Downloadable and Online Submission

Rutherford County Human Resources Department

289 N. Main St.

Rutherfordton, NC 28139

Phone: 828-287-6145 - Fax: 828-287-6262

 

These forms can be downloaded, printed, or submitted on-line and then mailed to the above address, emailed to debra.conner@rutherfordcountync.gov or faxed.

 

IT IS THE RESPONSIBILITY OF THE APPLICANT/EMPLOYEE TO CONTACT THE HUMAN RESOURCES OFFICE FOR VERIFICATION OF RECEIPT OR FORMS/APPLICATION.

 

On-line Job Application Submission System

 

Form 19—Employer’s Report of Employee’s Injury or Occupational Disease

OSHA’s Form 301 - Injury and Illness Incident Report

Worker's Comp. Pharmacy Card

 

Family Medical Leave Form(FMLA) for Employee

FMLA Form for Family Member

 

New Employee Password Request Form

 

New NC-4 Withholding Forms

 

2017 W4 Form

 

Ergonomic Sitting Graphic

 

Ergonomic Reminder Sheet

 

Ergonomic Check List

 

 This form can be downloaded to your personal computer, completed within excel with the correct information, printed, and faxed to the Flexible Benefit Management Company

 

Performance Evaluation Forms

 

These forms are the performance evaluation forms that each employee of Rutherford County viewed during their HR meetings