OPERS Independent Contractor/Worker Acknowledgement Form (PEDACKN)
An Ohio Public Employees Retirement System (OPERS) Independent Contractor/Worker Acknowledgement Form (PEDACKN) is required for:
- New independent contractors/sole proprietors
- 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.)
- 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.
- If the vendor does not have a Social Security Number (SSN), that field can be left blank, or their Employer Identification Number (EIN) can be written to the side and noted as EIN.
- 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