PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form IB-54
for the current year.
Form IB-54 Installment Payment for Self-insured Workers Compensation Group, Health Maintenance Organization, Hospital or Dental Corporation - North Carolina
What Is Form IB-54?
This is a legal form that was released by the North Carolina Department of Revenue - a government authority operating within North Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form IB-54?
A: Form IB-54 is a document used for installment payment for self-insured workers compensation group, health maintenance organization, hospital or dental corporation in North Carolina.
Q: Who needs to use Form IB-54?
A: Form IB-54 is used by self-insured workers compensation groups, health maintenance organizations, hospitals or dental corporations in North Carolina.
Q: What is the purpose of Form IB-54?
A: The purpose of Form IB-54 is to facilitate installment payments for self-insured workers compensation groups, health maintenance organizations, hospitals or dental corporations in North Carolina.
Q: Are there any filing fees associated with Form IB-54?
A: There are no filing fees associated with Form IB-54.
Q: What information is required on Form IB-54?
A: Form IB-54 requires information such as the entity's name, address, tax identification number, payment amount, and installment schedule.
Q: When should I submit Form IB-54?
A: Form IB-54 should be submitted in accordance with the installment schedule provided by the North Carolina Industrial Commission.
Q: What happens after I submit Form IB-54?
A: After submitting Form IB-54, the North Carolina Industrial Commission will review your installment payment plan and notify you of its approval or any additional requirements.
Q: Can I make changes to my installment payment plan?
A: Yes, changes to your installment payment plan can be made by submitting an amended Form IB-54 to the North Carolina Industrial Commission.
Q: What if I fail to make my installment payments?
A: Failure to make installment payments as scheduled may result in penalties and/or revocation of your self-insured status.
Form Details:
- Released on January 1, 2018;
- The latest edition provided by the North Carolina Department of Revenue;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form IB-54 by clicking the link below or browse more documents and templates provided by the North Carolina Department of Revenue.
Download Form IB-54 Installment Payment for Self-insured Workers Compensation Group, Health Maintenance Organization, Hospital or Dental Corporation - North Carolina
1
2
