EMPLOYEE/INDEPENDENT CONTRACTOR IDENTIFICATION FORM
Form Instructions
Enter the name of the current or former employee.
Enter the position title of the current or former employee.
Enter the department/business unit currently, or formerly, employed in the last two (2) years.
Enter the name of employee award, fellowship, or stipend and provide brief description, and how employee selected. If an employee award, proceed to the Suppler/Vender Servces section.
Provide a narratice of the specific duties performing or performed as/when an employee.
Enter the name of the department, business are, and/or student organization seeking the services of the current or former employee.
Provide a narrative of the specific services to be performed.
If approved to be a supplier/vendor, will an approved PSU contract be executed? Select Yes or No from the drop-down list.
Provide details as to if a current University employee is instructing, including detail oversight, or is the current employee/hiring department relying on the expertise of the individual? This excludes general guidelines.
Does the individual perform and/or offer the services to other clients? Select Yes or No from the drop-down list.
If yes selected in prior question, select Trade or Business from the drop-down list. If no, skip this entry.
If trade or business, enter the name of the business if not operating under individual name. If no, skip this entry.
Will the individual receive a flat fee or paid a set rate per hour? Select flat fee or set rate per hour from the drop-down list.
Enter the total amount to be paid.
Enter the name of the individual completing this form.
Select the date this form is being completed from the drop-down calendar.
The individual completing this form must provide either a hand-written signature or provide their digital ID (see the form instruction page for complete instructions on adding digital IDs).
Tax Services Use Only - Select Approved or Denied from the drop-down list.
Tax Services Use Only - Select the date this form was reviewed from the drop-down calendar.
Tax Services Use Only - Provide an explanation.
Tax Services Use Only - Tax Services must provide either a hand-written signature or provide their digital ID (see the form instruction page for complete instructions on adding digital IDs).
