OPERS Independent Contractor Form_fillable PDF Form (18).pdf

This document is an Independent Contractor/Worker Acknowledgment form issued by the Ohio Public Employees Retirement System (OPERS), located in Columbus, Ohio. The form is specifically designed for individuals who begin providing personal services to a public employer on or after January 7, 2013, but are not considered public employees (such as independent contractors). The form must be completed within 30 days of beginning service and requires detailed information about the individual's personal details and the public employer for whom services are being provided.

The form serves a critical administrative function by formally documenting the independent contractor status and ensuring that no retirement system contributions will be made for these services. It outlines specific criteria defining an independent contractor, including being party to a bilateral agreement, being paid a fee or contractual payment, not being eligible for employee benefits, not appearing on a public employer's payroll, providing personal 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 the possibility of requesting a determination of retirement system eligibility within five years of service and potential limitations on medical reimbursement arrangements for non-employee contractors.