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If you are certain an employee/employer relationship exists between the State and the Worker complete only items 1-4 on this and the next page of this questionnaire and sign title and date the certification on page 7. The following questions are correlated to correspond with the 20 COMMON LAW FACTORS set forth in IRS Regulations as being indicative of whether or not an employee/employer relationship exists. Reset Form Print Form DHR-CC4019 11/03 Office of the State Controller Form 319 ...Employment Relationship Questionnaire This information is needed in order to help determine whether the worker is an employee or an independent contractor for social security and income tax withholding purposes. This QUESTIONNAIRE should be completed for any individual on a personal service agreement for which there may be a question as to employment tax status. All items should be answered marked Unknown or Does not apply. If you need more space for Remarks on the last page attach another...sheet. If you need help in completing this form contact the State Controller s Office at 919 733-0178. Agency Name Worker s Name Agency Address Worker s Address Agency Federal Identification Number Worker s Social Security Number Date Worker s Services Performed FromTo Month day year Describe the agency s business a Please list the worker s occupation or title. b Describe the work performed by this individual* c Please attach a Job Announcement for this position if available. Page 1 of 7...S/Pers/Ragan/Emp Rel Questionnaire. doc a If the work was done under a written agreement or contract please attach a copy. b If the agreement was not in writing describe the terms and conditions or the work assignment. c If the actual working arrangement differed in any way from the written agreement explain the Differences why they occurred and the date or dates of such changes. d Are any other workers in this category given written agreements or contracts If so who are they At this point if...you are satisfied the above named worker providing service under a personal service agreement is an employee for purposes of FICA and Income Tax withholding stop here and to to page 9 and sign title and date the certification* If not satisfied please complete the questionnaire. For Yes or No Questions please check one. INSTRUCTIONS b Is the worker given instructions in the way the work is to be done YesNo If yes give specific examples. c Attach representative copies of any written instructions...or procedures. c Does your agency have the right to change the methods used by the worker or direct that person on how to do the work YesNo Explain your answer TRAINING answer the following What kind How often b Was the worker required to work with a trained employee of agency YesNo INTEGRATION INTO BUSINESS OPERATIONS a Does the operation of the agency s business require that the worker be supervised or controlled in the performance of the service YesNo SERVICES RENDERED PERSONNALY a Is it...understood that the worker will perform the services personally and not assign or delegate YesNo HIRING SUPERVISING AND PAYING ASSISTANTS Does the worker have helpers YesNo If yes Are helpers hired by Agency Worker.

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Understanding the Employer Employee Relationship Project Form

What is the employer employee relationship project form

The employer employee relationship project form is a document designed to help clarify the nature of the relationship between an employer and a worker. It is essential for determining whether a worker qualifies as an employee or an independent contractor for tax and other legal purposes. The form typically collects relevant information about the worker's duties, the terms of employment, and the business's operational framework.

Key Features of the employer employee relationship project form

This form includes several vital features to facilitate accurate assessment, such as sections for recording the worker's name, the agency’s information, job description, and employment agreements. Additionally, it contains fields for clarifying whether the working relationship aligns with specific employment tax guidelines. The structured format ensures comprehensive reporting and clarity for all parties involved.

Required Documents and Information

To complete the employer employee relationship project form, specific documents and information are necessary. Required details include the worker’s Social Security number, the agency's Federal Identification Number, and a detailed job description. If applicable, copies of any written contracts or agreements should also be attached to this form. Ensuring the accuracy of the provided information is crucial for compliance.

How to Fill the employer employee relationship project form

Filling out the employer employee relationship project form involves several steps. Start by entering the worker’s and agency’s details in the provided fields. Carefully describe the worker’s job responsibilities and the nature of the working relationship. If there are any written agreements, illustrate how these relate to the work performed. All questions should be answered thoroughly, indicating if certain fields do not apply. It is essential to have a clear understanding of the employment relationship to complete the form accurately.

Common Errors and Troubleshooting

Several common errors can occur when completing the employer employee relationship project form. Misunderstanding the distinction between an employee and an independent contractor can lead to inaccurate information. Omitting required documentation or providing incomplete responses may also cause issues. To avoid these pitfalls, it is advisable to double-check all entries and ensure that all supporting documents are attached. If clarification is needed, consulting the appropriate legal or HR resources can be beneficial.

Frequently Asked Questions about employee employer relationship questionnaire form

What is the purpose of the employer employee relationship project form?

The employer employee relationship project form helps determine the classification of a worker as either an employee or an independent contractor for employment tax purposes.

Who should complete the employer employee relationship project form?

Typically, the employer or agency that hires the worker is responsible for completing the form, ensuring that all relevant details regarding the employment relationship are accurately represented.