Contingent Worker Classification Screening Form

Screening form to evaluate whether a contingent worker should be engaged as an independent contractor or employee before onboarding a 1099 worker.

Submission Notice

• Purpose of this screening
• Requestor name
• Requestor department
• Planned start date
• Worker name or legal entity name
  Enter the individual name or business entity name that will perform the work. Collect only what is needed for review.
• Brief engagement summary
  Summarize the work, expected deliverables, and why this role is being proposed as contractor work.

Work Relationship Basics

• Primary work location
• Will the company provide tools, equipment, or software?
• Who sets the work schedule?
• Level of supervision expected
• Can the worker send a qualified substitute or delegate work?
• How integrated is the role into day-to-day operations?

IRS Common-Law Factors

• Will the company direct how the work is performed?
• Will the company provide training specific to how the work must be done?
• Who bears the financial risk for profit or loss?
• Will the company reimburse routine business expenses?
• How will the worker be paid?
• Can the worker market similar services to other clients?

DOL Economic Reality Test

• Does the worker have an opportunity for profit or loss based on managerial skill?
• Will the worker make a meaningful investment in tools, equipment, or business operations?
• Expected duration of the relationship
• Is the work integral to the company's core business?
• Does the role require specialized skill or independent expertise?
• Is the worker operating through a registered business entity?

Risk Indicators and Exceptions

• Will the worker use a company email address or employee-style account?
• Will the worker appear on the company org chart or internal headcount reports?
• Will the worker receive employee benefits or perks beyond standard vendor access?
• Will the worker be expected to work exclusively for the company?
• Explain any facts that could indicate employee status
  Include any control, supervision, scheduling, integration, or financial dependence concerns.

Consent, Review, and Audit Trail

• I understand this form collects only information needed for classification review and may be shared with HR, Legal, Procurement, or Tax for compliance purposes.
• I confirm the information provided is accurate and complete to the best of my knowledge.
• Reviewer notes
  For HR, Legal, or Compliance use only. Document the audit trail, decision rationale, and any required follow-up.