Is/was the individual an employee or affiliated with the University at any point during the past?
During the past year, is/was the individual an employee of the University?
IU ID Number:
Is the work similar to the duties performed as an IU employee?
Describe the employee duties performed for IU:
Describe the services the individual is being engaged to perform:
Are the services being performed outside the US?
Period of performance for independent contractor services (mm/dd/yyyy):
Total amount of payment for all known agreements:
Is the individual customarily engaged in an independently established trade, occupation,
profession, or business of the same nature as that involved in the service being performed
as an indenpendent contractor?
Does the individual have a FEIN Tax Payer Identification Number?
Will the individual be teaching or performing research services?
Is the individual integrated into IU's staff? In other words, is he/she essential to the completion
of daily operations?
Does IU provide instructions as to where work is performed?
Does IU provide instructions as to what hours will be worked?
Does IU provide instructions as how the work is performed?
Does IU provide the workstation for the person and most of the tools, materials,
and supplies needed to perform the work?
Are individual’s methods or activities controlled or directly supervised by an IU employee?
Is the individual providing services similar to those provided by a current IU employee?
Is the individual paid an hourly wage for a workday, rather than on a per-job basis?
Does IU provide training for the person?
Does IU provide other persons to assist the individual in performing the work?
Is the working relationship continuing, even if it is irregular or infrequent?
Does IU assume all risk of monetary loss on the project? In other words, is there no chance
the individual will lose money if the service is not satisfactory or complete?
Is the individual performing the type of work only for IU (not for any other clients)?
Does IU expect to hire the individual as an employee immediately following
the termination of his or her services as an independent contractor?
Will the individual be imparting knowledge or skills to students by serving as a teacher, lecturer, or instructor for the prospective independent contractor service?
Will the individual be performing research services such as conducting investigations to establish facts or principles or collecting information on a subject for the prospective independent contractor service?
Is the individual a "guest lecturer" (e.g., an individual who teaches/lectures/instructs
at only one or two class sessions during the semester)?
Is the individual the primary instructor of a course, be it for college credit,
continuing education credit, or non-credit?
Please select the appropriate relationship:
The individual will perform research for a University
professor/doctor under an arrangement whereby the University professor/doctor
serves in a supervisory capacity (e.g., the individual will be working under the
direction of the University professor/doctor).
The individual will serve in an advisory or consulting capacity
with a University professor/doctor (e.g., the individual is considered an expert in their field and will be working with
the University professor/doctor in a "collaboration between equals" type arrangement).
Does the individual routinely provide the same or similar services to the
general public as part of a continuing trade or business with the opportunity
for profit of loss?
Does the individual offer their services to the general public through advertising,
solicitations, brokers, or similar activities?
Does the individual provide services under a registered or licensed business name?
Does the individual have a written contract for a specific period of time ( less than 30
consecutive days) or to complete a specific result which also identifies the
individual as an independent contractor for federal tax purposes?
Will the University set the number of hours and/or days of the week that the
individual is required to work, as opposed to allowing the individual to set their
own work schedule?
Will the department provide this individual with specific instructions regarding
performance of the required work rather than rely on the individual's expertise?