NC State University

(Ex: 11.15.1 or REG 11.15.1)

Purchasing Department

Form

Contractual and Consultant Services
Independent Contractor Status Form

North Carolina State University
"Checklist For Determination Of Independent Contractor Status"

To ensure that agreements or contacts with individuals are properly classified for employment status according to Internal Revenue Service guidelines, this checklist MUST be completed for all personal service contracts and forwarded to the Purchasing Department with the contract or agreement for review.

For the individual to be categorized as an independent contractor and not an employee, the answers to the majority of the following questions should be YES. If you have any questions or need assistance in completing the checklist, please call the University Controller at 5-3824. If the contract does not address the stated issue, please indicate "not stated."

  YES NO

  1. Does the contract state that the University has no right to control how the work is performed? (Note: Control level is only on an end product or result.)

  _____  _____
  1. Does the contract state how the independent contractual obligations are met?
  _____  _____
  1. Does the contract state that the independent contractor has a right to hire and fire assistants?
  _____  _____
  1. Does the contract state that the independent contractor will treat controlled assistant as employees of the contractor and comply with all tax requirements?
 _____  _____
  1. Is the independent contractor paid by the job, rather than by the hour?
  _____  _____
  1.  Is the independent contractor viewed as a skilled worker?
  _____  _____
  1. Is the independent contractor hired for a specified time period?
  _____  _____
  1. Are the hours of work set by the independent contractor?
  _____  _____
  1. Does the independent contractor advertise and project an image to the public as an individual in private business? For example, does the independent contractor utilize business cards, advertise in the yellow pages or advertise on the side of a truck or van?
  _____  _____
  1. Does the University consistently refer to the worker as an independent contractor in letters, memoranda, invoices, check stubs, and other correspondence between the parties? 
  _____  _____
  1. Does the independent contractor furnish the tools used?
    
  1. Is the independent contractor engaged by the University to do something that is not part of the day-to-day operations of the University?
  _____  _____

ADDITIONAL COMMENTS:

______________________________________________
Contractor Name
______________________________________________ 
Contractor FID/SSN Identification
______________________________________________ 
Date of Contract
Prepared by: ______________________________________________
Name
______________________________________________ 
Title
______________________________________________
Phone No.

Rev. (07/2000)