Name of Independent Contractor: ______________________________________________
Project Title: ________________________________________________________________
Brief Description of Work:
Project Begin Date: ___________________ Project End Date: ___________________
The common law factor and control test is used as a primary vehicle in making a determination of whether
the individual should be an employee or an independent contractor. Evidence of the individual’s
classification must be documented in order to support the final determination. Please answer the following
questions truthfully and to the best of your knowledge. There is no “magic” or set number of factors that
“makes” the individual an employee or an independent contractor and no one factor stands alone in making
this determination. HR uses its professional discretion to look at the entire relationship, considers the
degree or extent of the right to direct and control work and documents each of the factors used in coming
up with the final determination.
Common Law Factor
1. Does MCC pay other employees to perform
those being performed by this individual?
functions which are the same or similar to
2. Is this individual currently an employee of MCC?
3. Has the individual
12 months?
been MCC’s payroll (regular or temporary) at any time in the past
4. Would MCC want to hire this individual as an employee immediately following the
termination of his/her services as an independent contractor?
5. Does this individual currently work as an independent contractor or consultant for
MCC OR has this individual worked as an independent contractor or consultant for
MCC in the past 12 months?
6. Will the individual be trained by MCC to perform the services in question?
7. Is the individual instructed about when, where and how work is to be done?
8. Will the individual have control over hiring and supervising personnel or assistants?
9. Is the individual required to perform the services personally?
10. Will the individual be required to provide regular progress reports?
11. Will the individual perform the services in
a prescribed sequence determined by
12. Is the individual required to devote a specific amount of time to performing services?
13. Will MCC provide the individual with any equipment, tools or supplies?
14. Is the individual required to work specific hours?
15. Will the individual perform services on MCC’s campus?
16. Could the individual realize a profit or loss as a result of the work to be performed?
17. Does the individual have a significant investment in tools
instruments that would be used to perform the work?
or other types of
18. Can the individual make his or her services available to the
term of the service agreement?
general public during the
19. Can the individual perform his or her services for more than one business?
Human Resources | Revised October 8, 2018
Common Law Factor
20. Will the individual paid by the: hour week month assignment?
21. Will the individual be reimbursed for business expenses?
22. Will the individual’s services by integrated into MCC’s educational or other activities?
23. Is there a written contract that set forth the terms and conditions of the services?
24. Does the individual earn employee benefits from MCC?
25. Is the individual incorporated?
26. Does the individual have a continuing relationship with MCC?
27. Can the individual be terminated at MCC’s discretion?
28. Can the individual end his or her relationship with MCC at any time?
Human Resources | Revised October 8, 2018