Upon submission of this form, an email will be sent to the address provided above. The email will contain an attached PDF and a link to a PDF of the form you completed. Please print your form and return with payment.
Checks/money orders are made payable to NCBOESLPA, and should be mailed to:
PO Box 16885
Greensboro, NC 27416
The form and check/money order MUST come together. If a check/money order comes in without a form, or vice versa, it will be returned to the sender.