Independent Contractor Qualification

Ind epen dent Contract or Q ua li fic ation Purpose: The following questions are for your use in determining whether you are correctly being paid as an Independent Contractor, or whether you should be treated as a regular taxable employee. While it may appear that you will make more money under this arrangement, you should be aware of the following: 1. The recipient of your services will make no tax or benefit deductions from your paycheck. Payments will be made based upon a schedule established between you and your client (“The EMPLOYER”), which may or may not follow its regular payment plan to its employees. 2. Instead of receiving a from W-2 for your earnings, you will instead be issued a Form 1099. Your employer has no responsibility for making any tax deductions. 3. You are not entitled to any benefits offered by The EMPLOYER to its employees. You are operating your own business, and as such are responsible for all expenses which you incur during the course of executing this work. 4. Specifically you should be aware that The EMPLOYER has no liability for Workmen’s Compensation or any disability you may suffer as a result of performance of work for the company. 5. While you will be receiving a larger take-home check, since no deductions are being taken by the employer, you should be aware that your tax obligations as an Independent Contractor will be greater than they would be as a regular employee. Put an X in the column that correctly answers each question. In the event that any Question, other than Questions 16 is answered “Yes,” or that item 16 is answered “No,” you have failed to qualify as an Independent contractor. No

Yes

Questions 1. Are you required to comply with instructions about when, where and how the work is done? 2. Are you provided training that would enable you to perform your work for the recipient of your services, in a particular method or manner? 3. Are the services provided you an integral part of the business' operations? 4. Must the services be rendered personally by you? 5. Does the recipient of your services hire, supervise, or pay assistants to help the you perform your work? 6. Is there a continuing relationship between you and the person or organization, for whom the services are performed? 7. Does the recipient of the services set the work schedule?

8. Are you required to devote your full time to the person or company you perform services for? 9. Is the work performed at the place of business of the company or at specific places set by the company? 10. Does the recipient of the services direct the sequence in which the work must be done? 11. Are regular oral or written reports required to be submitted by the worker? 12. Is the method of payment hourly, weekly, monthly (as opposed to commission or by the job?) 13. Are business and/or traveling expenses reimbursed? 14. Does the company furnish tools and materials used by the worker? 15. Have you failed to invest in equipment or facilities used to provide the services? 16. Do the terms and conditions of your work put you in a position of realizing either a profit or loss on the work? 17. Does the worker perform services exclusively for the company rather than working for a number of companies at the same time? 18. Do you, in fact, make your services regularly available to the general public? 19. Are you subject to dismissal for reasons other than nonperformance of the contract specifications? 20. Can you terminate your relationship to the recipient without incurring a liability for failure to complete the job?