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independent contractor information form

FIND YOUR NEXT CHALLENGE WITH THE ARRISON GROUP!

At The Arrison Group LLC, we believe in building a family atmosphere that fosters work-life balance and encourages career growth and performance. We take pride in celebrating success and sharing our success with our team. Come join us today

Contractor Information

Applications are considered for all independent contractors, and contractors are treated during the agreement,

without regard to race, color, religion, sex, national origin, age, disability, or any other prohibited basis of

discrimination as provided under applicable state and federal law.

References

Upload File
Are you legally eligible to work in USA?
Have you contated with The Arrison Group Before?
Do you have Liability and/or Malpractice Insurane? (If yes, email proof to: info@arrisongroup.com)
Do you agree to obtain any and all licenses that may be required to do business as an independent contractor or self-employed person?
Do you understand that as an independent contractor, you would not be eligible for unemployment benefits at the end of any contract with The Arrison Group?
Do you understand that as an independent contractor, you would be responsible for payment of any and all state and/or federal income taxes, Social Security, self-employment taxes, unemployment taxes, and payroll taxes and you will receive a form 1099 for service provided to The Arrison Group by you?

SIGNATURE/CERTIFICATION

 

I certify that the facts set forth in this application are true, complete, and correct to the best of my knowledge. I

understand that any misrepresentations, falsifications, or omissions on this application can be grounds for immediate

denial of my appointment or removal from consideration or, if I have entered into a contract with this company, for

immediate termination of that contract. I authorize The Arrison Group, LLC to make any necessary inquiries and investigations into my education, references, or employment history. I further authorize, unless otherwise indicated on this application, the

release of my information to The Arrison Group, LLC by any of the schools, services, or employers listed on this application.

 

I also hereby release from liability The Arrison Group, LLC and its representatives for seeking, gathering, and using such information to make decisions concerning my status as an independent contractor for The Arrison Group, LLC and all other persons or organizations for providing such information.

THIS IS NOT AN APPLICATION FOR EMPLOYMENT. I understand and agree that if this application is accepted,

my status will be that of an independent contractor and as such, I will be solely responsible for all tax liabilities

pertaining to monies received in the course of services I perform.

 

If I am retained by HHA as an independent contractor I will:

     • Not be entitled to workers compensation benefits.

     • Not be entitled to unemployment insurance benefits unless unemployment coverage is provided by me or some

other entity.

     • Be obligated to pay federal and state income tax on any moneys paid pursuant to the contract.

     • Be required to provide professional and liability insurance.

 

I represent and warrant that I have read and fully understand the foregoing, and that I seek to become and

independent contractor under these conditions. 

Affirm by typing your electronic signature and date below.

Thank you for your submission, you will be contacted shortly.

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