Skip to main content

How to Apply for Individual/Group PEO

<h3>Related Files</h3> <ul> <li><a href="https://www.ncdoi.gov/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="https://www.ncdoi.gov/documents/professional-employer-organization/peo-01-application">PEO-01 Application</a></li> <li><a href="https://www.ncdoi.gov/documents/professional-employer-organization/peo-02-biographical-affidavit">PEO-02 Biographical Affidavit</a></li> <li><a href="https://www.ncdoi.gov/documents/professional-employer-organization/peo-03-unconditional-cross-guaranty">PEO-03 Unconditional Cross Guaranty</a></li> <li><a href="https://www.ncdoi.gov/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="https://www.ncdoi.gov/documents/professional-employer-organization/peo-05-obligations-attestation">PEO-05 Obligations Attestation</a></li> <li><a href="https://www.ncdoi.gov/documents/professional-employer-organization/peo-06-ceo-and-cfo-fin-stmt-attest">PEO-06 CEO and CFO Fin Stmt Attest</a></li> <li><a href="https://www.ncdoi.gov/documents/professional-employer-organization/peo-07-power-attorney-assign-securities">PEO-07 Power of Attorney (Assign Securities)</a></li> <li><a href="https://www.ncdoi.gov/documents/professional-employer-organization/peo-08-surety-bond">PEO-08 Surety Bond</a></li> <li><a href="https://www.ncdoi.gov/documents/professional-employer-organization/peo-09-irrevocable-letter-credit">PEO-09 Irrevocable Letter Of Credit</a></li> <li><a href="https://www.ncdoi.gov/documents/professional-employer-organization/peo-14-unconditional-guaranty-agreement">PEO-14 Unconditional Guaranty Agreement</a></li> <li><a href="https://www.ncdoi.gov/documents/professional-employer-organization/peo-15-fingerprint-instructions">PEO-15 Fingerprint Instructions</a></li> <li><a href="https://www.ncdoi.gov/documents/professional-employer-organization/peo-16-corporate-resolution-guarantor">PEO-16 Corporate Resolution Of Guarantor</a></li> <li><a href="https://www.ncdoi.gov/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-22-parental-guaranty-peo">PEO-22 Parental Guaranty For PEO</a></li> </ul>

Steps

  1. Important

    The application 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 must be either typed or written in ink.

  3. Submit Additional Information

    Additional pages should be submitted indicating the specific items for which the additional information is being provided if extra space is required to respond to any of the items in the application.

  4. Payment

    The payment of the application fee must be mailed at the time the application is submitted.

  5. Required

    The surety bond, letter of credit, or cash deposit required pursuant to N.C.G.S. § 58-89A-50 must be submitted with the application.

  6. Submit To

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

  7. Name

    A license, if issued, will be in the name of the Applicant.

  8. 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.

  9. Before You Submit

    Please call Christine Williams at 919-807-6612 prior to submitting the application.