OPERS Independent Contractor Form_fillable PDF Form.pdf

The document is an OPERS (Ohio Public Employees Retirement System) Independent Contractor/Worker Acknowledgment form designed for individuals providing personal services to a public employer on or after January 7, 2013, who are not considered public employees. The two-page form requires independent contractors to complete personal information, public employer details, and acknowledge their classification status, with a requirement to submit the form within 30 days of beginning service provision.

The form outlines specific criteria defining an independent contractor under Ohio Administrative Code, including being party to a bilateral agreement, being paid a fee for particular services, 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 emphasizes that independent contractors are not public employees and will not have retirement system contributions made on their behalf, with potential implications for future retirement benefits and medical account eligibility. The form requires the contractor's signature and understanding of their classification, with a warning that failure of the public employer to retain this acknowledgment may extend the contractor's right to request a determination beyond the standard five-year period.