The NC DSS-8113 wage verification form is a one-page document that North Carolina’s county Department of Social Services uses to confirm your income when you apply for Food and Nutrition Services (SNAP) or Medicaid. Your employer fills out most of it, not you. Once it comes back to your caseworker with verified pay data, the county uses it to approve, deny, or adjust your benefits.
Where To Get the Form
You can download the DSS-8113 as a free PDF from the NC DHHS policies portal at policies.ncdhhs.gov.1North Carolina Department of Health & Human Services. DSS-8113: Wage Verification Form A Spanish version, DSS-8113sp (Formulario de Verificación de Sueldo), is on the same portal.2NC Department of Health & Human Services. DSS-8113sp: Formulario de Verificación de Sueldo
In most cases you won’t need to download anything. The county DSS office handling your case will pre-fill the top of the form with your case information and either mail it directly to your employer or hand it to you to deliver. You can also pick up a blank at your local county DSS office; every one of North Carolina’s 100 counties has one, and NCDHHS keeps a searchable directory online.3North Carolina Department of Health and Human Services. Local DSS Directory
What Your Employer Will Be Asked To Report
Knowing what the form asks for helps you brief your payroll contact before handing it over. The DSS-8113 is a snapshot of your whole employment and pay picture, not just recent paychecks.4North Carolina Department of Health and Human Services. Wage Verification Form It covers your start date and first paycheck date, pay frequency and payday, pay rate, weekly hours, and a row-by-row pay history showing hours worked, gross pay, tips, bonus and vacation pay, and any Earned Income Tax Credit amounts for each recent pay period. It also asks whether your employer expects any upcoming change to your pay, how many days you work per pay period, whether the company helps pay for child care, and whether you have employer-sponsored health insurance (and if so, the carrier, certificate number, effective date, and who is covered). If you’ve left the job, it asks the reason, the termination date, your final pay date, and your gross income during your last month.
Only your name is required for employee identification. The last four digits of your Social Security Number are optional, and the full SSN is not requested. Every dollar figure on the form is gross pay. Net pay and deductions aren’t collected.
Your Role as the Applicant
Your part is small but time-sensitive. When you signed your benefits application, you already authorized the county DSS to contact your employer about your income, and the form itself reminds the employer of that consent.4North Carolina Department of Health and Human Services. Wage Verification Form You do not sign a separate authorization on the DSS-8113.
If the county office hands you the form to deliver, take it to your employer’s payroll or human resources department right away. There’s a return-by date printed on the form, and missing it is one of the most common reasons applications stall. Make clear to your employer that the completed form goes back to the county DSS office, not to you, using the enclosed envelope or the fax number on the form.
If you work more than one job, expect a separate DSS-8113 for each employer. Every source of earned income has to be verified independently.
What Your Employer Does With It
The form states that it “must be completed by the employer.”4North Carolina Department of Health and Human Services. Wage Verification Form The employer or an authorized payroll representative fills in the pay sections from company records, then signs the bottom and prints their name, job title, the date, and a direct phone number. That phone number matters: your caseworker may call to clarify an entry or resolve a discrepancy. Employers should keep a photocopy for their records, since a similar request may come back at recertification.
How the Form Gets Back to the County
In most cases the employer returns the form directly to the county DSS office. Common ways to send it back:
- The pre-addressed return envelope the county typically encloses.
- Fax to the county number written on the form.
- Hand delivery to the county DSS office by the employer or the applicant.
- Online upload through North Carolina’s ePASS portal at epass.nc.gov, where available.
If you’re the one dropping it off or mailing it, keep a copy of the completed, signed form. Certified mail gives you a tracking number as proof of submission if the office later says it never arrived.
What Happens After It’s Submitted
Once the county has your verified wages, the caseworker folds them into the household income calculation and issues a written decision by mail. Timelines depend on the program. For Food and Nutrition Services, federal law requires a decision within 30 days of the date you applied, with expedited processing in seven days for households in urgent financial need.5Food and Nutrition Service. SNAP Eligibility For Medicaid, the standard window is up to 45 days, or up to 90 days for disability-related applications.6NC Medicaid. How To Apply for NC Medicaid If the return-by date passes without confirmation that your employer sent the form, call payroll and check.
Report Your Income Accurately
Because the employer fills in the pay data independently, your caseworker can compare it against what you reported on your application. Honest mistakes are handled differently from deliberate misreporting, but an Intentional Program Violation finding for SNAP can disqualify you from benefits for 12 months on a first offense, 24 months on a second, and permanently on a third, on top of repayment of any benefits you weren’t entitled to.7North Carolina Department of Health and Human Services. FNS 825 Intentional Program Violation (IPV) Disqualifications Reporting your income accurately and letting the DSS-8113 confirm it is the straightforward path.