Thank you for applying to become a Wake County precinct official.
Please submit these forms to complete the application process.
1. Taxpayer Identification Number Request
This form is REQUIRED by Wake County in order to pay you for your service.
2. Electronic Funds Transfer Authorization (Direct Deposit Signup)
This form is OPTIONAL and allows you to receive payment by direct deposit into a
checking or savings account. If you choose not to sign up for direct deposit, you
will receive payment as a paper check mailed to your home address.
You may type your information into the fields on the forms, then print and
sign them. If you choose to complete the forms by hand, please write legibly.
Mail the completed form(s) to:
Wake County Board of Elections
PO Box 695
Raleigh, NC 27602
IF SIGNING UP FOR DIRECT DEPOSIT,
REMEMBER TO INCLUDE A VOIDED CHECK
(or voided deposit slip for savings account)
Instructions:
1. Type information in all fields below or write legibly.
2. All fields highlighted in yellow are required.
3. Print the form.
4. Sign the form.
5. Mail the form to the address below.
TAXPAYER IDENTIFICATION NUMBER REQUEST FORM FOR ELECTION OFFICIALS
PURPOSE:
The purpose of this form is to verify your social security number. This is required by Wake County in order to issue payment to you
for your services as an election official. According the IRS guidelines, Wake County must issue a W-2 form to any individual who
earns $600.00 or more during a tax year (January 1-December 31) for services that he/she has provided.
A W-2 form will not be issued for any individual who earns less than $600.00 during the tax year.
Income received as an election official is not subject to tax withholding; however, any individual who earns $1,600.00 or more during
the 2015 tax year is subject to FICA (social security and Medicare) withholding. If you have any questions on whether or not you
should report these earnings on your personal income tax return please contact your tax advisor.
PART 1 - TAX STATUS:
INDIVIDUAL:
NAME: ____________________________________________________________
Individual’s Social Security #: _________________________________________
MAILING ADDRESS:
Address: ________________________________________________________
(number, street, and apt. or suite no.)
City: _____________________________ State: _______ Zip: ______________
PART 2 - CERTIFICATION:
Under penalties of perjury, I certify that:
The number shown on this form is my correct taxpayer number (or I am waiting for a number to be issued to me), and
I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been
notified by the IRS that I am subject to backup withholding as a result of a failure to report all interest or
dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding and
3. I am a U.S. person (including a U.S. resident alien).
1.
2.
Person completing this form: _________________________________________________________________
Date: ______________________ Phone: __________________________ Fax: ________________________
Signature: ______________________________________________________________
Mail this form back to:
Wake County Board of Elections
Attn: Staffing Team
PO Box 695
Raleigh, NC 27602
If you have questions, please call Wake County Finance Department at (919) 856-6120.
DIRECT DEPOSIT OPTION FOR PRECINCT OFFICIAL PAYMENT
We are excited to inform you that you are eligible to receive your election stipend by direct deposit. This service is
convenient and safe, and it allows you to receive payment for your election service faster than waiting for a check to
arrive by mail.
How does direct deposit work?
• You sign up by completing and mailing the form on the back of this letter and documentation from your bank.
• After each election you work, the county deposits your election stipend into your checking or savings account.
• You receive an email within 3-4 weeks of each election notifying you of your payment amount and deposit date.
If you have questions about direct deposit, please contact:
Sonya Hicks
Telephone:
Email:
(919) 856-5523
[email protected]
How Do I Sign Up For Direct Deposit?
1. Complete the Electronic Funds Transfer Authorization form on the
next page.
2. Attach bank documentation:
• Voided check for direct deposit into a checking account
or
• Voided deposit slip for direct deposit into a savings account
3. Mail the form using the address listed on the form.
If you prefer to e-mail or fax your information, contact Sonya Hicks for more information.
Five Reasons to Choose Direct Deposit
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Receive your election payment faster.
No trip to the bank to deposit a check.
No worries that a check will get lost or delayed in the mail.
No worries that a check will get returned undeliverable if you have moved.
Save taxpayer funds through elimination of paper and postage costs.
I want to receive my checks by mail. What do I need to do?
Nothing. You do not need to call or e-mail us, and there are no forms to fill out.
Revised 4/30/2015
Electronic Funds Transfer Authorization
Please, first read and follow instructions carefully to prevent delay in processing. All fields are required.
I authorize Wake County access to the account below in order to electronically deposit or draft funds in
accordance with our payment obligations. Further, I certify that the information below is correct. I agree
to provide 20 days written notice to Wake County Finance Department, PO Box 550, Raleigh, NC 27602
Attn: ACH Notification, prior to revoking this authorization.
Change
New
Please type into the fields below or print and write legibly. All fields highlighted in yellow are required.
PAYEE
Precinct Official Full Name:
Precinct Official Address:
City:
State:
Zip Code:
Daytime Phone Number:
Social Security Number:
BANK INFORMATION
Your Bank’s Name:
Choose Account Type (select one):
Bank’s Phone Number:
 CHECKING
 SAVINGS
Verify Depository Routing Number & Account Number with your bank and indicate below.
Routing Number:
Account Number:
How do I find my routing number and account number? Refer to the graphic on the previous page.
NOTIFICATION OF PAYMENT
Paper notifications will not be sent. Remittance information will be sent to you by e-mail.
Email Address (required):
Your Signature:
Date:
Your Printed Name:
MAIL THIS FORM TO:
Wake County Board of Elections
Attn: Staffing Team
PO Box 695
Raleigh, NC 27602
REMEMBER TO INCLUDE A VOIDED CHECK
(or voided deposit slip for savings account)
All Pages
Only the Forms (pages 2, 4)