Client confirmation of working practices

Full name of worker to which this information relates*

Name of Client organisation (your company)*

Full name and job title of individual completing this form*

Engagement Start Date

Engagement End Date (if known)

Has the worker been engaged for the purposes of a specific project?*

Yes
No

If yes, what is the nature of the project?

Please provide some brief detail on the services the worker provides*

Full name and job title of the individual to whom the worker will report (if not the person completing this form)

Which party decides the location at which the work is done?*

The worker
The client (you)
Agreed between worker and client
The client's customer

Which party decides the hours at / days on which the work is done?*

The worker
The client (you)
Agreed between worker and client
The client's customer

Can you instruct the worker to do other work outside of what has been agreed and specified above?*

Yes
No

Please provide further details if necessary

Do you have the right to instruct the worker in relation to their working methods?*

This pertains to the technical manner in which the work is done (rather than outcomes) and does not include the requirement to comply with regulatory or statutory frameworks

Yes
No

If yes, please provide further details

Please provide details of any rules, policies or procedures governing your employees that also apply to the worker*

E.g. health & safety, data protection, any HR policies or procedures etc

Please provide details on how you keep track of the worker's progress, how frequent this is and whether the work is subject to monitoring or overview*

Does the worker have the right to send a suitably qualified substitute, for any reason, to perform their work during the engagement?*

By answering "yes", you confirm that you would not reject any substitute if they have the required skills, qualifications and experience required to perform the services and that the worker's intermediary would be responsible for paying the substitute

Yes
No

Has substitution ever occurred?*

Yes
No
N/A - engagement has not yet started

Does the worker have the right to subcontract or assign elements of the work to another party?*

Yes
No

Are you obliged to provide the worker with continuous work throughout the period of engagement?*

Yes
No

Are you obliged to pay the worker if there is no work available during the period of the engagement, including during any notice period?*

Yes
No

Please provide details of any of their own equipment / facilities the worker will use in the provision of the services*

E.g. laptop, software, tools etc

Is the worker obligated to compensate you for any damage or loss caused by their negligence?*

Yes
No

Do you expect the worker to rectify any defective work in their own time and at their own expense?*

Yes
No

Do you place any restrictions on the worker working for other customers or clients during the course of the engagement?*

Yes
No

If yes, please provide further details

Is the worker entitled to any benefits that are available to your employees?*

E.g. performance bonuses, paid-for training, holiday/sick pay, overtime, memberships etc.

Yes
No

If yes, please provide further details

Does the worker work within a team?*

Please provide further details if necessary

Do you have any employees who carry out the same or similar work to the worker?*

Yes
No

If yes, please provide further details

Is the worker responsible for managing any of your employees*

No
Project management only
Line management

Please provide further details if necessary

If the worker is working / interacting with your customers, how do they represent themselves?*

They work for their own business
They are an independent contractor acting on your behalf
They work for you
Not applicable

What is the basis of payment?*

Please provide further details if necessary

Do you expect the contract will be extended and if so what is the likely duration?*

Further Information

Please provide any further information which may be relevant to this assessment

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Client confirmation of working practices

Confirmation of arrangements

Further Information

The status / IR35 / Off-Payroll experts

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