Fillable Printable Report Of Independent Contractor(S) (De 542)
Fillable Printable Report Of Independent Contractor(S) (De 542)
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Report Of Independent Contractor(S) (De 542)
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REPORT OF
INDEPENDENT CONTRACTOR(S)
05420101
See detailed instructions on reverse side. Please type or print.
SERVICE-PROVIDER (INDEPENDENT CONTRACTOR):
ADDRESS
DATE
CA EMPLOYER ACCOUNT NUMBER
SERVICE-RECIPIENT (BUSINESS OR GOVERNMENT ENTITY):
SERVICE-RECIPIENT NAME / BUSINESS NAME
SOCIAL SECURITY NUMBER
PHONE
NUMBER
FEDERAL ID NUMBER
ZIP CODE
CONTACT PERSON
CITY
STATE
FIRST NAME
MI
LAST NAME
START DATE OF CONTRACT
CONTRACT EXPIRATION DATE CHECK HERE IF CONTRACT IS ONGOING
CHECK HERE IF CONTRACT IS ONGOING
CHECK HERE IF CONTRACT IS ONGOING
SOCIAL SECURITY NUMBER
STREET NUMBER
STREET NAME
UNIT/APT
ZIP CODE
STATE
CITY
FIRST NAME
MI
LAST NAME
START DATE OF CONTRACT
CONTRACT EXPIRATION DATE
SOCIAL SECURITY NUMBER
STREET NUMBER STREET NAME UNIT/APT
ZIP CODE
STATE
CITY
FIRST NAME
MI
LAST NAME
START DATE OF CONTRACT
CONTRACT EXPIRATION DATE
SOCIAL SECURITY NUMBER
STREET NUMBER
STREET NAME
UNIT/APT
ZIP CODE
STATE
CITY
M M D D Y Y
M M D D Y Y
M M D D Y Y
M M D D Y Y
M M D D Y Y
M M D D Y Y
AMOUNT OF CONTRACT
AMOUNT OF CONTRACT
AMOUNT OF CONTRACT
,
,
,
,
,
,
.
.
.
MAIL TO: Employment Development Department • PO Box 997350, MIC 96 • Sacramento, CA 95899-7350
or Fax to 916-319-4410
DE 542 Rev. 9 (6-17) (INTERNET) Page 1 of 2
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INSTRUCTIONS FOR COMPLETING ALL OF THE ELEMENTS ON THE
REPORT OF INDEPENDENT CONTRACTOR(S), DE 542
WHO MUST REPORT:
Any business or government entity (dened as a “Service-Recipient”) that is required to le a federal Form 1099-MISC
for service performed by an independent contractor (dened as a “Service-Provider”) must report. You must report to the
Employment Development Department (EDD) within 20 days of EITHER making payments of $600 or more OR entering into a
contract for $600 or more with an independent contractor in any calendar year, whichever is earlier. This information is used to
assist state and county agencies in locating parents who are delinquent in their child support obligations.
An independent contractor is further dened as an individual who is not an employee of the business or government entity
for California purposes and who receives compensation or executes a contract for services performed for that business or
government entity either in or outside of California. For further clarication, request Information Sheet: Employment Work Status
Determination, DE 231ES. See below for information on how to obtain additional forms.
YOU ARE REQUIRED TO PROVIDE THE FOLLOWING INFORMATION THAT APPLIES:
HOW TO COMPLETE THIS FORM:
If you use a typewriter or printer, ignore the boxes and type in UPPER CASE as shown. Do not use commas or periods.
If you handwrite this form, print each letter or number in a separate box as shown. Do not use commas or periods.
ADDITIONAL INFORMATION:
If you have questions concerning the independent contractor reporting requirement, you may visit our web page at
www.edd.ca.gov/Payroll_Taxes/Independent_Contractor_Reporting.htm, call the New Employee Registry and Independent
Contractor Reporting at 916-657-0529, call the Taxpayer Assistance Center at 888-745-3886, or visit your local Employment Tax
Ofce listed in the California Employer’s Guide, DE 44, and on our web page at www.edd.ca.gov/Ofce_Locator/.
To obtain additional DE 542 forms:
• Visit the EDD website at www.edd.ca.gov/Forms/.
• For 25 or more forms, call 916-322-2835.
• For less than 25 forms, call 916-657-0529 or call 888-745-3886.
HOW TO REPORT:
For a fast, easy, and secure way to report your independent contractor information, use e-Services for Business.
For more information or to enroll, visit www.edd.ca.gov/e-Services_for_Business.
To le a paper DE 542 form, complete all of the information on the reverse side of this form and fax it to 916-319-4410 or
mail it to:
EMPLOYMENT DEVELOPMENT DEPARTMENT
PO Box 997350, MIC 96
Sacramento, CA 95899-7350
Service-Recipient (Business or Government Entity)
• Federal Employer Identication Number (FEIN)
• California employer payroll tax account number
(if applicable)
• Social Security number
• Service-recipient name/business name, address,
and phone number
• Contact person
Service-Provider (Independent Contractor)
• First name, middle initial, and last name
• Social Security number (do not use FEIN)
• Address
• Start date of contract (if no contract, date
payments equal $600 or more)
• Amount of contract (including cents)
• Contract expiration date or check the box if the
contract is ongoing
FIRST NAME LAST NAMEMI
SOCIAL SECURITY NUMBER
I M O G E N E A S A M P L E
X X X X X X X X X 1 2 3 4 5 M A I N S T R E E T 3 0 1
STREET NAME
STREET NUMBER
UNIT / APT.
FIRST NAME LAST NAMEMI
SOCIAL SECURITY NUMBER
IMOGENE A SAMPLE
STREET NUMBER
STREET NAME
UNIT / APT.
xxxxxxxxx 12345 MAIN STREET 301
DE 542 Rev. 9 (6-17) (INTERNET)
Page 2 of 2
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