The DWC 11 IC form is a document used in Rhode Island to officially designate an individual as an independent contractor, rather than an employee. By signing this form, the individual acknowledges that they are not entitled to workers' compensation benefits for injuries sustained while working as an independent contractor. It is important to understand the implications of this designation, as it affects eligibility for certain benefits.
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The DWC 11 IC form serves a crucial role in the landscape of independent contracting within the state of Rhode Island. This document, officially titled "Notice of Designation as Independent Contractor," is issued by the Rhode Island Department of Labor and Training, specifically under the Division of Workers’ Compensation. By signing this form, individuals declare their status as independent contractors, thereby acknowledging that they are not entitled to workers’ compensation benefits for any injuries sustained while working. It is essential to understand that this form does not automatically classify someone as an independent contractor under federal tax regulations; it strictly pertains to workers’ compensation laws. The form requires personal information, such as the contractor's name, business name, and Social Security number, as well as details about the hiring entity. A significant warning accompanies this form, emphasizing that no one can compel an individual to sign it, and that misrepresentation of employment status could lead to serious legal consequences. Furthermore, the form remains valid as long as services are rendered to the specified hiring entity or until a withdrawal form is submitted. For those uncertain about their classification as independent contractors or employees, guidance is available through the Rhode Island Division of Taxation and the IRS. Understanding the implications of this form is vital for both independent contractors and hiring entities to ensure compliance with state laws and to protect their rights.
Completing the DWC 11 IC form is a straightforward process. This form is necessary for individuals who wish to declare their status as independent contractors in Rhode Island. After filling out the form, it must be submitted to the Department of Labor and Training. A confirmation of the filing will be sent to the independent contractor within five business days.
Once completed, submit the form to the Department of Labor and Training at the address provided on the form. Keep a copy for your records. If you have any questions during the process, you can contact the Division of Workers’ Compensation for assistance.
The DWC 11 IC form is an essential document for individuals designating themselves as independent contractors in Rhode Island. Alongside this form, several other documents are often utilized to ensure compliance with state regulations and to clarify the relationship between independent contractors and hiring entities. The following is a list of these related forms and documents.
Each of these documents plays a vital role in the process of establishing and maintaining a clear understanding of the independent contractor relationship. Proper completion and submission of these forms help ensure compliance with relevant laws and protect the rights of all parties involved.
What is the DWC 11 IC form?
The DWC 11 IC form is a Notice of Designation as Independent Contractor issued by the State of Rhode Island's Department of Labor and Training. It indicates that an individual is declaring themselves as an independent contractor and not an employee. This designation means the individual is not entitled to workers' compensation benefits for any injuries sustained while working for the hiring entity listed on the form.
Who needs to complete the DWC 11 IC form?
What are the implications of signing the DWC 11 IC form?
By signing the DWC 11 IC form, you confirm that you are an independent contractor. This means you are waiving your rights to workers' compensation benefits for any injuries that occur while working for the hiring entity. It is crucial to understand that signing this form is voluntary and cannot be forced upon you.
How long does the designation as an independent contractor last?
The designation remains in effect while you are performing services for the hiring entity listed on the form. If you stop working for that entity, you must complete and submit a separate form, the Notice of Withdrawal of Designation as Independent Contractor (DWC-11-ICR), to officially end your designation.
What should I do if I feel coerced into signing the form?
If you believe you have been coerced or forced to sign the DWC 11 IC form, it is important to report this situation. You can contact the Workers’ Compensation Fraud and Compliance Unit at (401) 462-8100, option 7, to discuss your concerns and seek assistance.
Will my information be kept confidential?
No, the information provided on the DWC 11 IC form is not confidential. It will be shared with the Department of Labor and Training, the Rhode Island Division of Taxation, and the Internal Revenue Service. Additionally, the information is available to the public, including the hiring entity’s workers' compensation insurance carrier.
What if I have questions about my status as an independent contractor?
If you have questions regarding whether you are an independent contractor or an employee, you should reach out to the Rhode Island Division of Taxation at (401) 222-3682 or the Internal Revenue Service at 800-829-1040 for clarification and guidance.
How can I confirm that my DWC 11 IC form has been processed?
The Department of Labor and Training will mail a confirmation of your filing to you within five business days. If you have not received confirmation within this timeframe, you may want to contact the Division of Workers’ Compensation at (401) 462-8100, option 5, for further assistance.
Filling out the DWC 11 IC form correctly is crucial for establishing your status as an independent contractor. Here are some essential do's and don'ts to keep in mind:
Filling out the DWC 11 IC form is an important step for individuals seeking to establish their status as independent contractors in Rhode Island. Here are some key takeaways to consider:
Being informed about the DWC 11 IC form can help you navigate your rights and responsibilities effectively. Take the time to understand your situation and seek assistance if needed.
State of Rhode Island, Department of Labor and Training, Division of Workers’ Compensation
P.O. Box 20190, Cranston, RI 02920-0942
Phone (401) 462-8100 TDD (401) 462-8084 www.dlt.ri.gov
NOTICE OF DESIGNATION AS INDEPENDENT CONTRACTOR PURSUANT TO RIGL §28-29-17.1
PLEASE READ OTHER SIDE
WARNING
No one can force you to sign this form. When you sign this form you are stating that you are an independent contractor and in the event of injury, are not entitled to workers' compensation benefits.
*(Name)
*Business Name
Address
Soc. Sec. No.
FEIN
Business License No.
Date of Birth
I declare that I am an independent contractor pursuant to RIGL §28-29-17.1 and, therefore, I am not eligible for nor entitled to Workers’ Compensation benefits pursuant to Title 28, Chapters 29-38, of the Workers’ Compensation Act of the State of Rhode Island for injuries sustained while working as an independent contractor for the hiring entity named below. This designation will remain in effect while performing services for the named hiring entity or until a withdrawal of designation as independent contractor form is filed with the Department of Labor and Training.
*Hiring Entity Name
*Address
Warning! This form is for purposes of Workers’ Compensation only and completion of this form does not mean that you are an Independent Contractor under the rules, regulations or statutes of the Internal Revenue Service or the RI Division of Taxation. Information on this form will be shared within the Dept. of Labor and Training, the RI Division of Taxation and the Internal Revenue Service.
Independent Contractor:
Signature
Date
A hiring entity that knowingly assists, aids and abets, solicits, conspires with or coerces an employee to misrepresent the employee’s status as an independent contractor may be subject to criminal prosecution under RIGL §28-33-17.3.
*This information is available to the public including the Hiring Entity’s Workers’ Compensation Insurance Carrier.
The Department will mail a confirmation of this filing to the independent contractor within five business days. If you have any questions, call 462-8100, option 5.
DWC-11-IC (3/2006)
DWC-11-IC Reverse Side
This is a form DWC11-IC, Designation of Independent Contractor. This means that you have stated that you are an independent contractor NOT an employee and are NOT eligible for Workers’ Compensation benefits.
Many factors are considered when determining whether someone is an employee or an independent contractor. Some of those factors are: independent contractors set their own work hours, have their own tools and work when and for whom they choose.
An employer generally does not have to withhold or pay any taxes on payment to independent contractors, such as social security, Medicare, unemployment and Temporary Disability Insurance (TDI).
This form is for purposes of Workers’ Compensation, and completion of this form does not mean that you are considered an Independent Contractor under the rules, regulations or statutes of the Internal Revenue Service or the R.I. Division of Taxation.
SHOULD YOU HAVE ANY QUESTIONS ABOUT WHETHER YOU ARE AN INDEPENDENT CONTRACTOR OR AN EMPLOYEE, PLEASE CONTACT THE RI DIVISION OF TAXATION AT (401) 222-3682, OR THE US GOVERNMENT INTERNAL REVENUE SERVICE AT 800-829-1040.
IF YOU FEEL YOU HAVE BEEN COERCED OR FORCED TO SIGN THE INDEPENDENT CONTRACTOR FORM, REPORT THIS TO THE WORKERS’ COMPENSATION FRAUD AND COMPLIANCE UNIT AT (401) 462-8100, option 7.
When your work as an independent contractor ends with this employer, complete and return the form titled Notice of Withdrawal of Designation as Independent Contractor , DWC-11-ICR, to the Dept. of Labor and Training, Division of Workers’ Compensation.
If you have a question, contact the Division of Workers’ Compensation at (401) 462-8100, option 5. For further information, contact the Workers’ Compensation Information Line at (401) 462-8100, option 1.
DWC-11-IC (3/2006) Side 2
Ri Str Eft - This form is a vital step in maintaining your retail business in Rhode Island.
In addition to its role as a legal receipt, the Motor Vehicle Bill of Sale form can also be accessed and customized through various online platforms, including smarttemplates.net, which offers fillable templates to streamline the process of creating this important document.
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Signing this form indicates your declaration as an independent contractor for workers’ compensation purposes only. It does not guarantee that you meet the IRS criteria for independent contractor status.
You can withdraw your designation as an independent contractor by completing and submitting the Notice of Withdrawal of Designation as Independent Contractor form when your work ends.
By signing the DWC 11 IC form, you acknowledge that you are not eligible for workers’ compensation benefits for injuries sustained while working as an independent contractor.
This form is specifically for workers' compensation purposes. Other criteria from the IRS and state taxation authorities may also apply to determine your status.
The form explicitly states that no one can force you to sign it. Signing should be a voluntary decision.
Hiring entities are not required to provide workers' compensation insurance for independent contractors, as they are not considered employees.
The information on this form is public and may be shared with various agencies, including the RI Division of Taxation and the IRS.
Independent contractors are responsible for their own taxes, including social security and Medicare, as employers do not withhold these amounts.
Signing this form does not provide job security. Your work as an independent contractor can end at any time, and you must submit a withdrawal form if you stop working for the hiring entity.
Independent contractors have different rights and protections compared to employees. They do not have access to benefits like unemployment insurance or workers' compensation.