Independent Contractor Pre-hire Information

Read this page to understand the Independent Contractor Pre-hire Information Form, and why you must submit it.

Background: A worker who provides services to UCSD may be an independent contractor, consultant, or employee. According to UC policy (PDF), you must make clear distinctions in the hiring practices of these three types of workers. The Independent Contractor Pre-hire Information Form is designed to assist you in making these distinctions.

Before you attempt to acquire the services of an independent contractor or consultant when the proposed worker is an individual, you must submit the Independent Contractor Pre-hire Information Form, along with your High Value Purchase Requisition.

The Independent Contractor Pre-hire Information Form (PDF) (Word file) is divided into six parts. You must complete parts one through five.

  • Part 1 (2 sections)
    • Requesting Department: As the requesting department, you complete this section to provide information about the requesting department, requisition, and department contact information.
    • Proposed Contractor Information: You must provide information about the proposed contractor, including name, address, FEIN (Federal Employer Identification Number) or SSN (Social Security Number), and status of citizenship.
  • Part 2 — Statement of Work Information: In this section, you to describe the services requested, how and where the work will be performed, period of performance, and rate of pay.
  • Part 3 — Multiple Relationships with the University: If the proposed worker is a UC employee, or is related to a UC employee, you disclose it in this section.
  • Part 4 — IRS Classification Factors Checklist: This section contains eight questions regarding the control UCSD will have over the worker. This section assists you in determining whether the worker is a contractor or employee.
  • Part 5 — Department Authorization: The requesting department verifies and signs the form here.
  • Part 6 — Procurement & Contracts Determination: The Procurement & Contracts manager or designee approves or rejects the request.

Campus departments, send the completed form to Patrick Little, Mail Code 0914, or fax to (858) 534-5803.

SIO departments, send the form to Robert Beiner, Mail Code 0210, or fax to (858) 534-9295.