
Form SS-8 (Rev. 12-2023)
Page 3
Part II Behavioral Control (Provide names and titles of specific individuals, if applicable.) (continued)
5 Is the worker required to complete reports? . . . . . . . . . . . . . . . . . . . . . . . Yes No
If “Yes,” attach examples.
6a How frequently does the worker perform services?
As scheduled As needed As available
Other (specify)
b Describe the worker’s primary services. Sales Timesheets Patient logs
Other (specify)
7 Where are the services performed? If more than one location, what percentage of the worker’s time is spent at each location?
Firm premises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
%
Worker’s office or shop . . . . . . . . . . . . . . . . . . . . . . . . . . . .
%
Customer’s location . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
%
Other (specify)
%
8a Is the worker required to attend meetings? . . . . . . . . . . . . . . . . . . . . . . .
Yes No
If “Yes,” what type of meetings?
Sales Staff Other (specify)
b Is the worker penalized if unable to attend a meeting? . . . . . . . . . . . . . . . . . . . . Yes No
If “Yes,” what is the penalty?
9 Is the worker required to provide the services personally? . . . . . . . . . . . . . . . . . . .
Yes No
10 Can the worker hire substitutes or helpers? . . . . . . . . . . . . . . . . . . . . . . .
Yes No
11 If the worker hires the substitutes or helpers, is approval required? . . . . . . . . . . . . . . . .
Yes No
If “Yes,” who approves the hiring?
Firm Other (specify)
12 Does the worker pay substitutes or helpers? . . . . . . . . . . . . . . . . . . . . . . . Yes No
If “Yes,” is the worker reimbursed? . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes No
If the worker is reimbursed, explain who reimburses them.
Part III Financial Control (Provide names and titles of specific individuals, if applicable.)
1a List the supplies, equipment, materials, and property provided by
The firm:
The worker:
b Are supplies, equipment, materials, or property provided by another party? . . . . . . . . . . . . . .
Yes No
If “Yes,” explain.
2 Does the worker lease equipment, space, or a facility? . . . . . . . . . . . . . . . . . . . . Yes No
If “Yes,” what are the terms of the lease? (Attach a copy or explanatory statement.)
3 Are expenses incurred by the worker in the performance of services for the firm? . . . . . . . . . . . . Yes No
If “Yes,” explain.
4a Are expenses reimbursed by the firm? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If “Yes,” provide the frequency and amount.
b Are expenses reimbursed by another party? . . . . . . . . . . . . . . . . . . . . . . . Yes No
If “Yes,” explain.
5a What type of pay does the worker receive? Salary Commission Hourly wage Piece work Lump sum
Other (specify)
b If paid commission, does the firm guarantee a minimum amount of pay? . . . . . . . . . . . . . . . Yes No
If “Yes,” explain.
6 Can the worker request advance pay? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If “Yes,” how often?
Daily Weekly Monthly Other (specify)
7 Whom does the customer pay? . . . . . . . . . . . . . . . . . . . . . . . . . Firm Worker
If worker, does the worker pay the total amount to the firm?
Yes No If “No,” explain.
8 Does the firm carry workers’ compensation insurance on the worker? . . . . . . . . . . . . . . . Yes No
Did you remember to answer all questions and
refer to the Instructions for Form SS-8 at www.irs.gov/pub/irs-pdf/iss8.pdf?
Form SS-8 (Rev. 12-2023)