Form Ss 8 North Carolina Office Of The State Controller

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319
Determination of Worker Status
OSC Form
for Purposes of Federal Employment Taxes
(Rev March 2002)
and Income Tax Withholding
performed
Name of agency for whom the worker
services
Workers name
Agency’s address (include Street address, city, state, and ZIP code)
Worker’s address (include Street address, apt no. city, state, and ZIP code)
Worker’s social security number and/or employer identification number (if any)
Telephone number (include area code)
(
)
OSC Form 319 is based on IRS Form SS-8, Determination of Worker Status for Purposes of Federal Employment Taxes and
Income Tax Withholding.
It has been modified to reflect the types of employment situations that would be found in a
governmental work environment. The agency should review all contractual relationships it enters into for potential employee
relationships. OSC Form 319 should be used only in situations where the distinction between employee and independent
contractor is not clearly defined.
Do not complete OSC Form 319 for all service agreements, just those where the determination is difficult. If an employment
relationship exists, the worker should be paid through the payroll system. If not, he/she should be paid through accounts
payable.
Once this determination has been made, OSC Form 319 should be filed with other documentation relevant to this worker’s
contract. Keep for a period of four years from the due date of the tax return involved (Form W-2 or Form 1099).
Answer ALL items OR mark “Unknown” or "Does not apply." Attach another sheet, if necessary .
A
This form is being completed for services performed from
to ________________ .
(beginning date)
(ending date)
B. Total number of workers who performed or are performing the same or similar services
.
C. How did the worker obtain the job? Application
Bid
Employment Agency
Other (specify).
D. If the work is done under a written agreement between the agency and the worker, attach a copy (preferably
signed by both parties). Describe the terms and conditions of the work arrangement.
E. Attach copies of other supporting documentation such as invoices, memos, IRS closing agreements IRS
audits or rulings, etc) applicable to this relationship determination. Determine if there exists any current or
past litigation concerning the worker’s status. Enter the amount of income earned for the year(s) in question
$
.
F. Describe the work performed by the worker and provide the worker’s job title.
Detail why you believe the worker is an employee or an independent contractor.
G.
H. Did the worker perform services for the agency before getting this position? Yes
No
N/A
.
If “Yes,” what were the dates of the prior service?
.
If “Yes,” explain the differences, if any, between the current and prior service.
PART I
Behavioral Control
1
What specific training and/or instruction is the worker given by the agency?

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