OPERS Independent Contractor Form_fillable PDF Form (18).pdf

This document is an Ohio Public Employees Retirement System (OPERS) Independent Contractor/Worker Acknowledgment form designed for individuals providing personal services to a public employer after January 7, 2013, who are not considered public employees. The form requires independent contractors to complete and submit documentation within 30 days of beginning service, acknowledging their classification and understanding that no retirement system contributions will be made on their behalf.

The form details specific criteria for independent contractor status under Ohio Administrative Code, including being party to a bilateral agreement, being paid by contractual arrangement, not being eligible for employee benefits, not appearing on a public employer's payroll, providing own supplies and equipment, and receiving an Internal Revenue Service Form 1099 for tax reporting. The document also explains potential implications for independent contractors, such as eligibility for medical determinations, restrictions on retirement system benefits, and the possibility of financial liability if contract classification is disputed. The form must be signed by the independent contractor, with a clear instruction not to print or type their name on the signature line.