OPERS_Independent_Contractor_Form_fillable_PDF_Form (2).pdf

This is an Independent Contractor/Worker Acknowledgment form issued by the Ohio Public Employees Retirement System (OPERS) for use by public employers in Ohio. The form is required for individuals who begin providing personal services to a public employer on or after January 7, 2013, but are not classified as public employees and will not have contributions made to OPERS. The form must be completed within 30 days of the service provider beginning work. The document collects essential personal information including the contractor's name, Social Security number, and date of birth, along with details about the public employer, employer contact information, employer code, and the specific dates of service commencement and completion.

The form serves as a formal acknowledgment and documentation mechanism for independent contractor relationships with Ohio public employers, ensuring compliance with OPERS regulations and proper classification of workers outside the public employee retirement system. Completion of this form is mandatory for all non-employee service providers engaging with public employers in Ohio and represents a standard administrative requirement for establishing the independent contractor status and distinguishing such arrangements from traditional public employment relationships subject to OPERS contributions.