Edd Form De 230 PDF Details

In today's job market, the distinction between being classified as an independent contractor or an employee is more relevant than ever, affecting millions of workers across various industries. The EDD De 230 form, provided by the State of California's Employment Development Department, serves as a critical tool in addressing and clarifying these classifications. Designed to cater to a wide range of work activities, this form allows workers who believe they might be misclassified as independent contractors to seek a preliminary classification assessment or to trigger an audit lead referral. The form requires detailed input about the worker's engagement with the firm, including job nature, payment methods, benefits, and the level of control the firm has over their work. By submitting this form, workers can either request the department's opinion on their employment status—an assessment made without notifying the firm unless explicitly permitted by the worker—or lead the department to consider auditing the firm for potential misclassification issues. Additionally, the form's design to accommodate anonymity for those who prefer not to disclose their identity to the firm underscores the EDD's commitment to protecting worker rights while encouraging compliance with the California Unemployment Insurance Code. The outcome of this assessment can significantly impact a worker's eligibility for employment-related benefits such as unemployment insurance, state disability insurance, and paid family leave, making the De 230 form a potentially life-changing document for many Californians.

QuestionAnswer
Form NameEdd Form De 230
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namesCALIFORNIA, 1a, FACD, 18e

Form Preview Example

Request for Preliminary Worker Classification

Assessment or Audit Lead Referral

Purpose

This form may be used by a worker who believes that he/she is

If you require assistance in the completion of this form, contact

misclassified as an independent contractor or to request the

the nearest Employment Tax Office, listed on our Web site at

Employment Development Department (EDD) to conduct an

www.edd.ca.gov/office_locator/, or call (888) 745-3886.

audit of a firm. Please indicate the action you wish EDD to take

 

by checking one of the boxes below.

Upon completion, return to:

This form is designed to cover many work activities. Some of the

STATE OF CALIFORNIA

questions may not apply to you. You should answer all of the

EMPLOYMENT DEVELOPMENT DEPARTMENT

questions or mark them “UNKNOWN” or “DOES NOT APPLY.” If

FACD – Central Operations, MIC 94

additional space is needed, please attach another sheet.

P.O. Box 826880

 

Sacramento, CA 94280-0001

 

 

Check either the “OPINION” or “AUDIT LEAD” box:

 

OPINION

I am requesting an opinion on whether I am an employee or an independent contractor of the firm for which I am currently working.

This opinion is for your information and the firm will not be notified of EDD’s opinion without your permission. However, it is EDD’s practice to encourage employer voluntary compliance.

Sharing the opinion with the firm will assist the firm in meeting its obligations under the California Unemployment Insurance Code. May EDD supply the firm with a copy of the opinion?

Yes

No

If you checked “No,” the firm will not be contacted. If you checked “Yes,” EDD’s notification to the firm will not include your name, address, social security number, or a copy of this form.

Our determination will not affect your future eligibility for employee-related benefits such as California Unemployment Insurance and State Disability Insurance*. If you file a claim for benefits, a separate determination will be made to determine your eligibility.

* Includes Paid Family Leave (PFL)

AUDIT LEAD

I am providing information to EDD as a potential employment tax audit lead. I recognize that if EDD does conduct an audit, this form may be shared with the firm.

The law provides that all information contained in the firm’s file be open to examination by the firm being audited. If you object to your name being disclosed to the firm, leave the worker identity portion of this form blank. (Copies of any contracts you have with the firm or other documentation that you attach to the questionnaire should have your name, address, and social security number blacked out in order to prevent your identity from being disclosed.)

If you wish to remain anonymous and are also requesting an opinion, please submit two separate requests (DE 230) with the worker identification completed for the “Opinion” request and the worker identity blank for the “Audit Lead.”

The information you provide will be forwarded to a local Employment Tax Office.

NAME OF WORKER

 

 

NAME OF FIRM

 

 

 

 

 

SOCIAL SECURITY NUMBER

 

NAME OF OWNER

 

 

 

 

 

 

ADDRESS

(CITY)

(STATE) (ZIP CODE)

ADDRESS OF FIRM (CITY)

(STATE) (ZIP CODE)

 

 

TELEPHONE NUMBER (INCLUDING AREA CODE)

TELEPHONE NUMBER (INCLUDING AREA CODE)

 

 

 

 

 

(Do not complete the worker identity information if you wish to remain anonymous.)

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1a. Are you currently working for this firm?

b. Date you were hired:

Yes

No

c. If you have been terminated, please provide the date and explain why you were terminated:

(If you are not currently working for this firm and you are requesting an opinion of your personal employment status, please do not submit this form because opinions are only provided to workers currently working

with the firm. Complete the remainder of the form only if you are submitting this as an audit lead or are currently working with the firm.)

2.Provide a brief description of the firm’s business (for example, drug store, farmer, construction):

3.State your occupation and title and give a complete description of the services you provide:

4.Estimate the number of workers performing the same services as you for the firm:

5.How did you learn of the job (for example, advertisement in newspaper, word of mouth):

6.What were the requirements for your position (for example, previous experience, education):

7.Are your services performed under a written agreement or contract? If “Yes,” please attach a copy.

Yes

No

8.If the agreement is not in writing, or the terms of the written agreement are not complied with in practice, describe the actual terms and conditions of the arrangement:

9a. How is your pay calculated:

Fixed Salary

Commission

Hourly Wage

Other

Amount: $

 

 

per month

$

 

per hour

If “Other,” please explain:

 

 

 

 

 

 

 

 

b. Are you guaranteed a minimum pay?

Yes

No

 

 

 

If “Yes,” please state the minimum pay and frequency of the payment.

 

 

 

10a. Are you paid by

cash or

check?

b. Are deductions made?

Yes

If “Yes,” what deductions are made?

No

11. If you performed services for the firm in the prior calendar year, did you receive a:

Other If “Other,” please explain:

Form 1099

Form W-2

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12.Does the firm provide you with a pension program, bonuses, paid vacations, sick pay, etc.? If “Yes,” explain:

Yes

No

13. Does the firm carry workers’ compensation insurance on you?

Yes

No

Unknown

14a. Can the firm discharge you at any time? If “Yes,” please explain:

Yes

No

b. Is any notice required? If “Yes,” please explain:

Yes

No

15a. Would you be liable to the firm if you quit before the job was complete? If “Yes,” please explain:

Yes

No

b. Would the firm be liable to you if the firm discharged you without notice or before the job was

 

 

complete?

Yes

No

 

 

 

 

If “Yes,” please explain:

 

 

 

 

16.

Was it agreed or understood that you would perform the services personally?

Yes

No

 

If “No,” please explain:

 

 

 

 

 

17a.

Do you have helpers?

Yes

No

 

 

If “Yes,” answer questions 17b through 17g.

If “No,” go to question 18.

b. Who hired the helpers?

You

The firm

c. Who can discharge the helpers?

You

The firm

d. Who pays the helpers?

You

The firm

e. If you pay the helpers, does the firm reimburse you?

Yes

No

f.What services do the helpers perform?

g.Are social security (FICA), state disability insurance (SDI), and income taxes withheld from the helpers’ wages?

Yes

No

Unknown

If “Yes,” who reports and pays these taxes?

18a. Does the firm allow you to provide services for other firms during the same time periods services are performed

for the firm?

Yes

No

Unknown

If “Yes,” answer questions 18b through 18e.

If “No,” or “Unknown,” go to question 19.

b. What percent of your total working time do you spend working for other firms?

c. What percent of your total income is earned from other firms?

d. Describe any services you performed for other firms:

e. Are you required to give the firm first priority over your work for other firms?

Yes

No

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19a. Do you provide any tools or equipment needed to perform services for the firm? If “Yes,” describe the tools and equipment and their approximate value:

Yes

No

b. List any tools, equipment, and/or facilities furnished by the firm and their approximate value:

20a. Do you incur any expenses that you pay in connection with the services you perform for the firm? Please discuss:

b. Are you reimbursed by the firm for any expenses?

Yes

If “Yes,” describe those expenses and the amounts reimbursed:

No

21. Do you perform services for the firm under:

Your business name

The firm’s name

22.Do you advertise or maintain a business listing in the telephone directory, a trade journal, Internet, etc.?

Yes No

23.Do you hold yourself out to the public as available to provide services of this nature? If “Yes,” please explain:

Yes

No

24.

Do you have an office or shop of your own?

Yes

No

 

 

 

 

 

If “Yes,” where (is the office in your home or is it rented office space?):

 

 

 

 

 

 

 

25a.

Is a license or certificate required to perform the services you perform for the firm?

Yes

No

 

If “Yes,” do you possess such a license or certificate?

Yes

No

 

 

b. By whom is the license or certificate issued (state type and number):

c. Who paid the license or certificate fee?

26. How does the firm engage your services:

If “Other,” please explain:

Full-time

Part-time

Particular job

Indefinite period

27.

Does the firm require you to perform your services during a scheduled time?

Yes

No

 

If “Yes,” please explain:

 

 

 

 

 

 

 

 

 

 

 

28.

Were you given training by the firm?

Yes

No

 

 

If “Yes,” what kind, how often, and who paid for the training expenses:

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29.Are you required to follow daily, weekly, etc., routines or schedules established by the firm? If “Yes,” please describe:

Yes

No

30.Does the firm give you instructions on how to perform your services? If “Yes,” explain the nature of the instructions:

Yes

No

31.

Can the firm change the methods you use in performing your services or otherwise direct you as to how to

 

perform your work?

Yes

No

 

Explain your answer:

 

 

 

 

 

32a.

Are you required to report to the firm or its representative on the status or progress of your services for

 

the firm?

Yes

No

 

 

If “Yes,” how often?

 

 

 

b. For what purpose?

c. In what manner (in person, in writing, by telephone, time record, e-mail, etc.)

Please attach copies of report forms used in reporting to the firm.

33. If you do not produce or accept a certain amount of work regularly, will the firm terminate your services?

Yes

No

If “Yes,” please explain:

34. How do you normally report earnings for income tax purposes?

Wages

Self-employment Income

35.Could you in any way incur a financial loss from the services that you perform for the firm? If “Yes,” please explain:

Yes

No

36. Has any other governmental agency ruled on the employment status of services performed by you for this firm?

Yes

No

If “Yes,” please attach a copy of the ruling and explain:

(If you wish to remain anonymous, do not complete below.)

I declare that all copies of contracts and all statements submitted are true, correct, and complete to the best of my knowledge and belief. If any misrepresentation has been made or facts have been omitted, I understand that the determination will not be valid and will not be binding upon the Department.

______________________________________ ______________________________________ ___________________

(NAME PRINTED)

(SIGNATURE)

(DATE)

 

 

 

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