Rev 1.0.022410
EMPLOYEE/INDEPENDENT CONTRACTOR CLASSIFICATION CHECKLIST
Individuals engaged to perform services for Wilkes University are presumed to be employees of the University. The information
provided below will assist the University in determining whether the individual performing the services will be classified for federal, state
and FICA tax purposes as an employee or considered an independent contractor. The checklist must be completed by the person
knowledgeable about the services to be rendered and responsible for engaging the service of the individual. Complete Sections I and II
and attach to a description of services to be provided if the checklist indicates that an individual is to be treated as an independent
contractor. Otherwise, follow the procedures for hiring a new employee.
I. General Information
_________________________ ______________________ _____________________
Individual’s Name Social Security No. or Individual Taxpayer ID Wilkes ID No. (WIN)
_________________________ ______________________ _________ ___________
Department Prepared By Date Phone No.
II. Relationship with the University
Answers in shaded section weigh in favor of treating person as an employee. Contact Payroll for assistance in determining
employment status.
YES NO
Was the person being paid through Payroll during the current or previous
calendar year(s)?
If Yes, was it for similar work?
Does the University have the right to control when, where, and how the work is
done?
Do you set the mandatory work hours?
Is the person required to perform the work personally?
Is the work performed on Wilkes University premises or using our facilities?
Is the worker required to follow your instructions in completing the job or task?
Is the worker allowed to delegate or assign the work to others and/or assistants
not currently working for Wilkes?
Is the worker paid by the hour, biweekly, or monthly, rather than at the
completion (or partial completion) of the project?
Are you required to pay the worker for time spent even if the job is not
completed?
Is the worker doing business as a corporation or using a legitimate business
name?
Does the employee have a federal employer identification number (not Soc.
Sec. #)? If so, please list above.
Does the worker carry his/her own business insurance?
Is Wilkes University the individual’s only client?
Is the work in question customarily performed by Wilkes University employees?
