OPERS Independent Contractor Form_fillable PDF Form.pdf

This is an Independent Contractor/Worker Acknowledgment form from the Ohio Public Employees Retirement System (OPERS) that must be completed by individuals providing personal services to Ohio public employers who are not classified as public employees. The form must be submitted within 30 days of beginning services and includes sections for personal information, public employer information, and acknowledgment of independent contractor status. The document outlines the criteria for independent contractor classification according to Ohio Administrative Code section 145-1-42(A)(2).

The form includes important provisions regarding OPERS contributions, benefits eligibility, and the contractor's rights. Contractors have five years from the start of services to request a determination of their employment classification status if they disagree with their independent contractor designation. The form specifies that independent contractors are not eligible for OPERS contributions, workers' compensation, unemployment compensation, or employee benefits. A signed copy must be retained by both the public employer and sent to OPERS, with the employer's failure to retain the acknowledgment potentially extending the contractor's right to request classification determination beyond the standard five-year period.