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How to Apply for De Minimis Registration

<h3>Related Files</h3> <ul> <li><a href="/documents/professional-employer-organization/form-01-132-15-authority-release-information">Form 01-132-15 Authority For Release Of Information</a></li> <li><a href="/documents/professional-employer-organization/peo-02-biographical-affidavit">PEO-02 Biographical Affidavit</a></li> <li><a href="/documents/professional-employer-organization/peo-04-power-attorney-service-legal-process">PEO-04 Power Of Attorney (Service Of Legal Process)</a></li> <li><a href="/documents/professional-employer-organization/peo-17-workers-comp-attest">PEO-17 Workers' Comp Attest</a></li> <li><a href="https://www.ncdoi.gov/documents/professional-employer-organization/peo-18-de-minimis-registration-notification">PEO-18 De Minimis Registration Notification</a></li> </ul>

Steps

  1. Important

    The application (opens in new tab) must be completed in its entirety. All questions must be answered and required items submitted. If an answer is "no", "none", or "not applicable", so state. No application will be considered completed until all requested information is received. 

  2. What To Use

    The application (opens in new tab) must be either typed or written in ink.

  3. Additional Information

    If extra space is required to respond to any of the items in the notification, additional pages should be attached indicating the specific items for which the additional information is being provided.

  4. Payment

    The payment of the application (opens in new tab) fee required pursuant to N.C.G.S. § 58-89A-65(a) must be mailed at the time the notification is submitted.

  5. Submission

    The completed notification should be submitted to: Christine.Williams@ncdoi.gov.

  6. Contact

    Please contact the Financial Analysis and Receivership Division of the North Carolina Department of Insurance, Special Entities Section via email to Christine.Williams@ncdoi.gov or via phone to 919-807-6612 if you have any questions.