Self-employment questionnaire

Name*
First Last
Agency name*
Your email address*
Job title*
What is your current self-employment tax status?*
Are you required to complete an annual self-employed self-assessment tax return?*
- Yes
- No

In relation to this assignment, in your opinion are you:*

	Yes	No
1. Entitled to any employee benefits such as holiday pay, sick pay or company pension scheme from Quest Pay Solutions NE Limited, the Agency or the Client?
2. Under any obligation to accept future assignments or contractually guaranteed to receive future assignments from Quest Pay Solutions NE Limited, the Agency or the Client?
3. Entitled to provide an alternative person to carry out the work you have contracted to do, subject to the prior agreement of the end Client?
4. Entitled at any time to terminate an assignment or work on more than one assignment at any time?
5. Other than when or where, other than health and safety instruction, does anyone supervise or direct you on how you do your work?
6. Do you consider you are responsible for your own management of your work on site?
7. Do you provide any of your own tools and equipment?

Please also answer these additional questions in relation to this assignment.*

	Yes	No
1. Do you have an unfettered right to substitution?
2. Do you have no mutuality of obligation?
3. Are you... not controlled, directed or supervised as to how you perform your work by anyone in the contractual chain (or subject to the rights of any such person to control, direct or supervise you)?
4. Do you take financial risk or are responsible for defects?
5. Do you have no statutory employment rights? e.g. holiday pay, AWR entitlement, statutory sick pay, unfair dismissal rights, etc.
6. Are you self-employed and responsible for paying taxes to HMRC?
7. Are you or will you be registered with HMRC as self-employed, and that evidence will be provided to document this within an acceptable time frame?
8. Can you confirm that your last piece of work was not as an employee of the end client carrying out similar work?
9. Can you confirm that you have not been previously engaged as an employee in a similar role with the same end client within 3 months of the current assignment?

By agreeing to this assessment you acknowledge that the responses you have provided above give a true and accurate description of the terms and conditions which apply to your engagement via Quest Pay Solutions NE Limited.

Should your working practices or your opinion to these questions change, it is requested that you contact Quest Pay Solutions NE Limited immediately to complete a new self-employed assessment, to ensure that you comply with the HMRC guidelines. Quest Pay Solutions NE Limited will use this assessment for the duration of your contract; therefore it is your responsibility to notify Quest Pay Solutions NE Limited of any changes.
Confirmation*
I agree to this assessment
Phone
This field is for validation purposes and should be left unchanged.