Determination of Independent Contractor Status

This form should only be completed to justify Independent Contractor Status. Please complete all sections. The need for proper classification of individuals in the workplace remains of paramount importance to the University. Misclassification deprives individuals of the many benefits, both public and private, that employees enjoy. The Commonwealth is also harmed by misclassification in the form of lost revenue and increased costs. Furthermore, misclassification undermines fair market competition and negatively impacts the business environment in the Commonwealth.

Upon submit, your completed form will be sent to you in email. This document should not be sent to UPST.

The service is to be performed must be outside the usual course of the business of the University. Note: This question covers the entire University System, not a particular department or location.

Departments may seek information and guidance on this issue from the appropriate campus or University Human Resources Department.

The individual must be customarily engaged in an independently established trade, occupation, profession or business of the same nature as the services to be performed.

On submission the responses you entered will be compiled to you in an email and attached as a PDF file for future reference. If you would like to include additional recipients, please add them below; you must click "Add another response" at the bottom of this section to add more email recipients.