OPERS Independent Contractor/Worker Acknowledgement Form (PEDACKN)

An Ohio Public Employees Retirement System (OPERS) Independent Contractor/Worker Acknowledgement Form (PEDACKN) is required for: 

  1. New independent contractors/sole proprietors 
  2. Payments that are submitted for an existing independent contractor or sole proprietor 

The PEDACKN form is not required for goods purchased or payments such as awards, honorariums, etc.) 

Additional details: 

  • OPERS will not accept any type of digital signature including DocuSign. An actual handwritten signature (wet signature) is required. 
  • If the services are being provided by someone marked as an LLC and the LLC is marked as “individual-US citizen” or “sole proprietor,” a PEDACKN form is required for services being performed. 
  • For Ohio State, the "employer code" is 1641, but the employer contact would be the name and phone number of the contact as set up with the vendor. 
  • For services start and end dates, if the end date is unknown, that field can be left blank or marked with N/A. If an end date is provided and the contractor returns later to perform additional work, a new form would need to be submitted with the new date range. 
  • The form is required regardless of where the vendor is located (out of state, international, etc.).   

For questions, please call Ohio Employees Retirement System at 1-888-400-0965