Form SS-8

(Rev. August 2011)

Department of the Treasury 

Internal Revenue Service

Determination of Worker Status for Purposes 

 of Federal Employment Taxes and 

Income Tax Withholding

OMB. No. 1545-0004

For IRS Use Only: 

Case Number: 

Earliest Receipt Date:

Name of firm (or person) for whom the worker performed services

Firm’s mailing address (include street address, apt. or suite no., city, state, and ZIP code)

Trade name Firm's email address

Firm's fax number Firm's website

Firm's telephone number (include area code) Firm’s employer identification number

Worker’s name

Worker’s mailing address (include street address, apt. or suite no., city, state, and ZIP code)

Worker's daytime telephone number Worker's email address

Worker's alternate telephone number Worker's fax number

Worker’s social security number Worker’s employer identification number (if any)

Note. If the worker is paid for these services by a firm other than the one listed on this form, enter the name, address, and employer identification

number of the payer. ▶

Disclosure of Information

The information provided on Form SS-8 may be disclosed to the firm, worker, or payer named above to assist the IRS in the determination process. 

For example, if you are a worker, we may disclose the information you provide on Form SS-8 to the firm or payer named above. The information can 

only be disclosed to assist with the determination process. If you provide incomplete information, we may not be able to process your request. See 

Privacy Act and Paperwork Reduction Act Notice on page 6 for more information. If you do not want this information disclosed to other parties, do 

not file Form SS-8.

Parts I–V. All filers of Form SS-8 must complete all questions in Parts I–IV. Part V must be completed if the worker provides a service directly to

customers or is a salesperson. If you cannot answer a question, enter “Unknown” or “Does not apply.” If you need more space for a question, attach

another sheet with the part and question number clearly identified. Write your firm's name (or workers' name) and employer identification number (or 

social security number) at the top of each additional sheet attached to this form.

Part I General Information

1 This form is being completed by: Firm Worker; for services performed

(beginning date)

to

(ending date)

.

2 Explain your reason(s) for filing this form (for example, you received a bill from the IRS, you believe you erroneously received a Form 1099 or 

Form W-2, you are unable to get worker’s compensation benefits, or you were audited or are being audited by the IRS).

3 Total number of workers who performed or are performing the same or similar services: .

4 How did the worker obtain the job? Application Bid Employment Agency Other (specify)

5 

 

Attach copies of all supporting documentation (for example, contracts, invoices, memos, Forms W-2 or Forms 1099-MISC issued or received, IRS 

closing agreements or IRS rulings). In addition, please inform us of any current or past litigation concerning the worker’s status. If no income reporting forms 

(Form 1099-MISC or W-2) were furnished to the worker, enter the amount of income earned for the year(s) at issue $ .

If both Form W-2 and Form 1099-MISC were issued or received, explain why.

6 Describe the firm’s business.

For Privacy Act and Paperwork Reduction Act Notice, see page 6. Cat. No. 16106T Form SS-8 (Rev. 8-2011)
Form SS-8 (Rev. 8-2011) Page 2

Part I General Information (continued)

7 If the worker received pay from more than one entity because of an event such as the sale, merger, acquisition, or reorganization of the firm for 

whom the services are performed, provide the following: Name of the firm's previous owner:

Previous owner's taxpayer identification number: Change was a: Sale Merger Acquisition Reorganization

Other (specify)

Description of above change:

Date of change (MM/DD/YY):

8 Describe the work done by the worker and provide the worker’s job title.

9 Explain why you believe the worker is an employee or an independent contractor.

10 Did the worker perform services for the firm in any capacity before providing the services that are the subject of this determination request?

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.

11 If the work is done under a written agreement between the firm and the worker, attach a copy (preferably signed by both parties). Describe the 

terms and conditions of the work arrangement.

Part II Behavioral Control (Provide names and titles of specific individuals, if applicable.)

1 What specific training and/or instruction is the worker given by the firm?

2 How does the worker receive work assignments?

3 Who determines the methods by which the assignments are performed?

4 Who is the worker required to contact if problems or complaints arise and who is responsible for their resolution?

5 What types of reports are required from the worker? Attach examples.

6 Describe the worker’s daily routine such as his or her schedule or hours.

7 At what location(s) does the worker perform services (for example, firm’s premises, own shop or office, home, customer’s location)? Indicate 

the appropriate percentage of time the worker spends in each location, if more than one.

8 Describe any meetings the worker is required to attend and any penalties for not attending (for example, sales meetings, monthly meetings, 

staff meetings).

9 Is the worker required to provide the services personally? . . . . . . . . . . . . . . . . . . . Yes No

10 If substitutes or helpers are needed, who hires them?

11 If the worker hires the substitutes or helpers, is approval required? . . . . . . . . . . . . . . . . Yes No

If “Yes,” by whom?

12 Who pays the substitutes or helpers?

13 Is the worker reimbursed if the worker pays the substitutes or helpers? . . . . . . . . . . . . . . . Yes No

If “Yes,” by whom?

Form SS-8 (Rev. 8-2011)
Form SS-8 (Rev. 8-2011) Page 3

Part III Financial Control (Provide names and titles of specific individuals, if applicable.)

1 List the supplies, equipment, materials, and property provided by each party:

The firm:

The worker:

Other party:

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 What expenses are incurred by the worker in the performance of services for the firm?

4 Specify which, if any, expenses are reimbursed by:

The firm:

Other party:

5 Type of pay the worker receives: Salary Commission Hourly Wage Piece Work

Lump Sum Other (specify)

If type of pay is commission, and the firm guarantees a minimum amount of pay, specify amount. $

6 Is the worker allowed a drawing account for advances? . . . . . . . . . . . . . . . . . . . Yes No

If “Yes,” how often?

Specify any restrictions.

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

9 What economic loss or financial risk, if any, can the worker incur beyond the normal loss of salary (for example, loss or damage of equipment, 

material)?

10 Does the worker establish the level of payment for the services provided or the products sold? . . . . . . . . Yes No

If “No,” who does?

Part IV Relationship of the Worker and Firm

1 Please check the benefits available to the worker: Paid vacations Sick pay Paid holidays

Personal days Pensions Insurance benefits Bonuses

Other (specify)

2 Can the relationship be terminated by either party without incurring liability or penalty? . . . . . . . . . . Yes No

If “No,” explain your answer.

3 Did the worker perform similar services for others during the time period entered in Part I, line 1? . . . . . . . Yes No

If “Yes,” is the worker required to get approval from the firm? . . . . . . . . . . . . . . . . . . Yes No

4 Describe any agreements prohibiting competition between the worker and the firm while the worker is performing services or during any later 

period. Attach any available documentation.

5 Is the worker a member of a union? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

6 What type of advertising, if any, does the worker do (for example, a business listing in a directory or business cards)? Provide copies, if 

applicable.

7 If the worker assembles or processes a product at home, who provides the materials and instructions or pattern?

8 What does the worker do with the finished product (for example, return it to the firm, provide it to another party, or sell it)?

9 How does the firm represent the worker to its customers (for example, employee, partner, representative, or contractor), and under whose 

business name does the worker perform these services?

10 If the worker no longer performs services for the firm, how did the relationship end (for example, worker quit or was fired, job completed, 

contract ended, firm or worker went out of business)?

Form SS-8 (Rev. 8-2011)
Form SS-8 (Rev. 8-2011) Page 4

Part V For Service Providers or Salespersons. Complete this part if the worker provided a service directly to

customers or is a salesperson.

1 What are the worker’s responsibilities in soliciting new customers?

2 Who provides the worker with leads to prospective customers?

3 Describe any reporting requirements pertaining to the leads.

4 What terms and conditions of sale, if any, are required by the firm?

5 Are orders submitted to and subject to approval by the firm? . . . . . . . . . . . . . . . . . . Yes No

6 Who determines the worker’s territory?

7 Did the worker pay for the privilege of serving customers on the route or in the territory? . . . . . . . . . . Yes No

If “Yes,” whom did the worker pay?

If “Yes,” how much did the worker pay? . . . . . . . . . . . . . . . . . . . . . $

8 Where does the worker sell the product (for example, in a home, retail establishment)?

9 List the product and/or services distributed by the worker (for example, meat, vegetables, fruit, bakery products, beverages, or laundry or dry 

cleaning services). If more than one type of product and/or service is distributed, specify the principal one.

10 Does the worker sell life insurance full time? . . . . . . . . . . . . . . . . . . . . . . . Yes No

11 Does the worker sell other types of insurance for the firm? . . . . . . . . . . . . . . . . . . . Yes No

If “Yes,” enter the percentage of the worker’s total working time spent in selling other types of insurance . . . . . %

12 If the worker solicits orders from wholesalers, retailers, contractors, or operators of hotels, restaurants, or other similar 

establishments, enter the percentage of the worker’s time spent in the solicitation . . . . . . . . . . . . %

13 Is the merchandise purchased by the customers for resale or use in their business operations? . . . . . . . . Yes No

Describe the merchandise and state whether it is equipment installed on the customers’ premises.

Sign 

Here

Under penalties of perjury, I declare that I have examined this request, including accompanying documents, and to the best of my knowledge and belief, the 

facts presented are true, correct, and complete.

▲

Type or print name below signature.

Title ▶ Date ▶

Form SS-8 (Rev. 8-2011)
Form SS-8 (Rev. 8-2011) Page 5

General Instructions

Section references are to the Internal Revenue Code unless 

otherwise noted.

Purpose

Firms and workers file Form SS-8 to request a determination of 

the status of a worker for purposes of federal employment taxes 

and income tax withholding.

A Form SS-8 determination may be requested only in order to 

resolve federal tax matters. If Form SS-8 is submitted for a tax 

year for which the statute of limitations on the tax return has 

expired, a determination letter will not be issued. The statute of 

limitations expires 3 years from the due date of the tax return or 

the date filed, whichever is later.

The IRS does not issue a determination letter for proposed 

transactions or on hypothetical situations. We may, however, 

issue an information letter when it is considered appropriate.

Definition

Firm. For the purposes of this form, the term “firm” means any

individual, business enterprise, organization, state, or other

entity for which a worker has performed services. The firm may 

or may not have paid the worker directly for these services.

▲!

CAUTION

If the firm was not responsible for payment for 

services, be sure to enter the name, address, and 

employer identification number of the payer on the 

first page of Form SS-8, below the identifying 

information for the firm and the worker.

The Form SS-8 Determination Process

The IRS will acknowledge the receipt of your Form SS-8. 

Because there are usually two (or more) parties who could be 

affected by a determination of employment status, the IRS 

attempts to get information from all parties involved by sending 

those parties blank Forms SS-8 for completion. Some or all of 

the information provided on this Form SS-8 may be shared with 

the other parties listed on page 1. The case will be assigned to a 

technician who will review the facts, apply the law, and render a 

decision. The technician may ask for additional information from 

the requestor, from other involved parties, or from third parties 

that could help clarify the work relationship before rendering a 

decision. The IRS will generally issue a formal determination to 

the firm or payer (if that is a different entity), and will send a 

copy to the worker. A determination letter applies only to a 

worker (or a class of workers) requesting it, and the decision is 

binding on the IRS. In certain cases, a formal determination will 

not be issued. Instead, an information letter may be issued. 

Although an information letter is advisory only and is not binding 

on the IRS, it may be used to assist the worker to fulfill his or her 

federal tax obligations.

Neither the Form SS-8 determination process nor the review 

of any records in connection with the determination constitutes 

an examination (audit) of any federal tax return. If the periods 

under consideration have previously been examined, the Form 

SS-8 determination process will not constitute a reexamination 

under IRS reopening procedures. Because this is not an 

examination of any federal tax return, the appeal rights available 

in connection with an examination do not apply to a Form SS-8 

determination. However, if you disagree with a determination or 

you have additional information concerning the work 

relationship that you believe was not previously considered, you 

may request that the determining office reconsider the 

determination.

Completing Form SS-8

Answer all questions as completely as possible. Attach 

additional sheets if you need more space. Provide information 

for all years the worker provided services for the firm. 

Determinations are based on the entire relationship between the 

firm and the worker. Also indicate if there were any significant 

changes in the work relationship over the service term.

Additional copies of this form may be obtained on IRS.gov or 

by calling 1-800-TAX-FORM (1-800-829-3676).

Fee

There is no fee for requesting a Form SS-8 determination letter.

Signature

Form SS-8 must be signed and dated by the taxpayer. A 

stamped signature will not be accepted.

The person who signs for a corporation must be an officer of 

the corporation who has personal knowledge of the facts. If the 

corporation is a member of an affiliated group filing a 

consolidated return, it must be signed by an officer of the 

common parent of the group.

The person signing for a trust, partnership, or limited liability 

company must be, respectively, a trustee, general partner, or 

member-manager who has personal knowledge of the facts.

Where To File

Send the completed and signed Form SS-8 to the address 

below for the firm's location. Faxed, photocopied, or electronic 

versions of Form SS-8 are not acceptable for the initial request 

for the Form SS-8 determination. However, only for cases 

involving federal agencies, send Form SS-8 to the Internal 

Revenue Service, Attn: CC:CORP:T:C, Ben Franklin Station, 

P.O. Box 7604, Washington, DC 20044. Do not submit Form 

SS-8 with your tax return as that will delay processing time.

Firm’s location: Send to:

Alaska, Arizona, Arkansas, 

California, Colorado, Hawaii, 

Idaho, Illinois, Iowa, Kansas, 

Minnesota, Missouri, Montana, 

Nebraska, Nevada, New 

Mexico, North Dakota, 

Oklahoma, Oregon, South 

Dakota, Texas, Utah, 

Washington, Wisconsin, 

Wyoming, American Samoa, 

Guam, Puerto Rico, U.S. Virgin 

Islands

Internal Revenue Service 

Form SS-8 Determinations 

P.O. Box 630 

Stop 631 

Holtsville, NY 11742-0630 

Alabama, Connecticut, 

Delaware, District of Columbia, 

Florida, Georgia, Indiana, 

Kentucky, Louisiana, Maine, 

Maryland, Massachusetts, 

Michigan, Mississippi, New 

Hampshire, New Jersey, New 

York, North Carolina, Ohio, 

Pennsylvania, Rhode Island, 

South Carolina, Tennessee, 

Vermont, Virginia, West Virginia, 

all other locations not listed

 

 

 

 

Internal Revenue Service 

Form SS-8 Determinations 

40 Lakemont Road 

Newport, VT 05855-1555 

 

 

Form SS-8 (Rev. 8-2011)
Form SS-8 (Rev. 8-2011) Page 6

Instructions for Workers

If you are requesting a determination for more than one firm, 

complete a separate Form SS-8 for each firm.

Form SS-8 is not a claim for refund of social security 

and Medicare taxes or federal income tax ▲! withholding. CAUTION

If the IRS determines that you are an employee, you are 

responsible for filing an amended return for any corrections 

related to this decision. A determination that a worker is an 

employee does not necessarily reduce any current or prior tax 

liability. For more information, call 1-800-829-1040.

Time for filing a claim for refund. Generally, you must file your 

claim for a credit or refund within 3 years from the date your 

original return was filed or within 2 years from the date the tax 

was paid, whichever is later.

Filing Form SS-8 does not prevent the expiration of the time 

in which a claim for a refund must be filed. If you are

concerned about a refund, and the statute of limitations for filing 

a claim for refund for the year(s) at issue has not yet expired, 

you should file Form 1040X, Amended U.S. Individual Income 

Tax Return, to protect your statute of limitations. File a separate 

Form 1040X for each year.

On the Form 1040X you file, do not complete lines 1 through 

22 on the form. Write “Protective Claim” at the top of the form, 

sign and date it. In addition, enter the following statement in 

Part III: “Filed Form SS-8 with the Internal Revenue Service 

Office in (Holtsville, NY; Newport, VT; or Washington, DC; as 

appropriate). By filing this protective claim, I reserve the right to 

file a claim for any refund that may be due after a determination 

of my employment tax status has been completed.”

Filing Form SS-8 does not alter the requirement to timely file 

an income tax return. Do not delay filing your tax return in 

anticipation of an answer to your Form SS-8 request. In 

addition, if applicable, do not delay in responding to a request 

for payment while waiting for a determination of your worker

status.

Instructions for Firms

If a worker has requested a determination of his or her status 

while working for you, you will receive a request from the IRS to 

complete a Form SS-8. In cases of this type, the IRS usually 

gives each party an opportunity to present a statement of the 

facts because any decision will affect the employment tax 

status of the parties. Failure to respond to this request will not 

prevent the IRS from issuing a determination letter based on the 

information he or she has made available so that the worker 

may fulfill his or her federal tax obligations. However, the 

information that you provide is extremely valuable in 

determining the status of the worker.

If you are requesting a determination for a particular class of 

worker, complete the form for one individual who is 

representative of the class of workers whose status is in 

question. If you want a written determination for more than one 

class of workers, complete a separate Form SS-8 for one 

worker from each class whose status is typical of that class. A 

written determination for any worker will apply to other workers 

of the same class if the facts are not materially different for 

these workers. Please provide a list of names and addresses of 

all workers potentially affected by this determination.

If you have a reasonable basis for not treating a worker as an 

employee, you may be relieved from having to pay employment 

taxes for that worker under section 530 of the 1978 Revenue 

Act. However, this relief provision cannot be considered in 

conjunction with a Form SS-8 determination because the 

determination does not constitute an examination of any tax 

return. For more information regarding section 530 of the 1978 

Revenue Act and to determine if you qualify for relief under this 

section, visit IRS.gov. 

Privacy Act and Paperwork Reduction Act Notice. We ask for 

the information on Form SS-8 to carry out the Internal Revenue 

laws of the United States. This information will be used to 

determine the employment status of the worker(s) described on 

the form. Subtitle C, Employment Taxes, of the Internal Revenue 

Code imposes employment taxes on wages, including income 

tax withholding. Sections 3121(d), 3306(a), and 3401(c) and (d) 

and the related regulations define employee and employer for

purposes of employment taxes imposed under Subtitle C.

Section 6001 authorizes the IRS to request information needed 

to determine if a worker(s) or firm is subject to these taxes. 

Section 6109 requires you to provide your taxpayer

identification number. Neither workers nor firms are required to 

request a status determination, but if you choose to do so, you 

must provide the information requested on this form. Failure to 

provide the requested information may prevent us from making 

a status determination. If any worker or the firm has requested a 

status determination and you are being asked to provide 

information for use in that determination, you are not required to 

provide the requested information. However, failure to provide 

such information will prevent the IRS from considering it in 

making the status determination. Providing false or fraudulent 

information may subject you to penalties. Generally, tax returns 

and return information are confidential, as required by section 

6103. However, section 6103 allows or requires the IRS to 

disclose or give the information shown on your tax return to 

others as described in the Code. Routine uses of this 

information include providing it to the Department of Justice for 

use in civil and criminal litigation, to the Social Security 

Administration for the administration of social security 

programs, and to cities, states, the District of Columbia, and 

U.S. commonwealths and possessions for the administration of

their tax laws. We also may disclose this information to other

countries under a tax treaty, to federal and state agencies to

enforce federal nontax criminal laws, or to federal law

enforcement and intelligence agencies to combat terrorism. We 

may provide this information to the affected worker(s), the firm, 

or payer as part of the status determination process.

You are not required to provide the information requested on 

a form that is subject to the Paperwork Reduction Act unless 

the form displays a valid OMB control number. Books or 

records relating to a form or its instructions must be retained as 

long as their contents may become material in the 

administration of any Internal Revenue law. 

The time needed to complete and file this Form SS-8 will vary 

depending on individual circumstances. The estimated average 

time is: Recordkeeping, 23 hrs., 55 min.; Learning about the law 

or the form, 1 hr., 48 min.; Preparing the form, 5 hrs., 03 min.; 

and Sending the form to the IRS, 48 min. If you have comments 

concerning the accuracy of these time estimates or suggestions 

for making this form simpler, we would be happy to hear from 

you. You can write to the Internal Revenue Service, Tax 

Products Coordinating Committee, SE:W:CAR:MP:T:M:S, 

1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. 

Do not send the tax form to this address. Instead, see Where To 

File on page 5.