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Independent Contractor Notice

Free Printable Independent Contractor Notice FormFree Printable Independent Contractor Notice Form

This review list is intended to educate you about the content of this document and to aid you in its preparation. This agreement shields the employer against IRS, state, and municipal assessments if it is determined that the Contractor does not fulfill the IRS qualifications for Contractor status at the time of the assessment. This effectively places the Contractor on the hook for any evaluations. Additionally, displaying this paper to an IRS, State, or municipal agent is likely to cause them to move on to another case or inquiry, since they are “pursuing” businesses, not people. They are likely to move on to other firms if they discover that the “Contractor” must “pay up.”


  1. Make several copies. Obtaining notarized copies is usually a good idea, since revenue

agents often adhere to legal formalities, and remember, this is for their benefit.

Independent Contractor Notice

You are acting as an independent contractor for ________________________. As an independent contractor, you should be aware of the following:

1. At the conclusion of the tax year, a report will be sent to the Internal Revenue Service and other local authorities of the gross amount earned.

2. No withholding of taxes takes place. You may have the obligation to pay periodic taxes or withholding towards the same. Please consult with a tax advisor of your choosing regarding the requirements. ________________________ cannot provide tax advice.

3. Your Federal Tax ID Number is: __________________________, for reporting purposes.

___________________ Date:
Independent Contractor

I, the principal officer of Independent Contractor, do hereby indemnify Customer from any additional tax liability should the IRS rule that we were acting as employees or otherwise assess any taxes upon the Customer. This indemnity shall also apply to any state or local taxes that may be assessed against Customer. I make this indemnity both as the Independent Contractor and as an individual guarantor.
___________________ ______________________
Independent Contractor, Principal Principal as an Individual
Social Security Number:

___________________ Date:
Independent Contractor Notice
Review List

This review list is provided to inform you about this document in question and assist you in its preparation. This document protects the employer, in part, from IRS, State, and local assessments if the Contractor is found to not meet the then IRS standards for Contractor status. This puts the Contractor squarely on the hook for any assessments. Just as importantly, showing this document to an IRS, State, or local agent is apt to make them move on to another case or investigation since they are “after” companies not individuals. If they find that the “Contractor” must “pay up,” they are apt to move on to other corporations.

1. Make multiple copies. Getting notarized copies is always a good idea since revenue agents tend to respect the legal niceties, and, remember, it is for them you are doing this.

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