Application For Predetermination Of Independent Contractor Status {WCB-260}

APPLICATION FOR PREDETERMINATION OF INDEPENDENT CONTRACTOR STATUS TO ESTABLISH CONCLUSIVE PRESUMPTION. This form is used in the State of Maine by landowners (or their agents) to formally request a ruling from the Maine Workers’ Compensation Board that a wood harvester performing services on their land qualifies as an independent contractor, not an employee. This form, when approved, establishes a conclusive presumption under Maine law that no employer-employee relationship exists for the purposes of workers’ compensation liability. The application collects detailed information about the contractual relationship, including the existence of a written wood harvesting agreement, whether the wood harvester employs or is authorized to hire assistants, which party supplies the tools and equipment, control over daily operations, duration and payment terms of the agreement, and whether the harvester works for other landowners. It also verifies that no employment-related withholdings (such as taxes or insurance) are made by the landowner. Both the landowner (or agent) and the wood harvester must sign the form, certifying that the information is accurate and acknowledging that any changes to the circumstances may invalidate the predetermination. www.FormsWorkflow.com