Independent Contractor Information Form |

Independent Contractor Information Form

Nevada County Publishing Company – The Union newspaper

Please complete form in its entirety and be prepared to provide 1-3 below.

  1. DMV printout of your driving record for the last 10 years, or as long as you have been driving if less than 10 years.
  2. A copy of your current driver’s license.
  3. A copy of the current vehicle insurance for the vehicle listed below.

Name of prospective contractor*

Address 1*

Address 2




Cell Phone* (with area code)

Evening Phone* (with area code)

Social Security Or Taxpayer ID Number (for 1099 reporting) *

Have you previously operated a business as an independent contractor?*

If yes, where?

The Union is a Monday – Saturday morning newspaper. In addition we distribute additional publications that include Sunday morning delivery. We promote to subscribers that newspapers will arrive prior to 6 a.m. With that understanding will you be able to deliver newspapers under contract with that delivery promise?

Independent contractors must provide their own vehicles. Please provide the make, model, and year of the vehicle(s) that you propose to use for delivery. *

If for some reason you experience vehicle problems, The Union does not provide backup or replacement vehicles. As an independent contractor that would be your responsibility. Do you have access to a suitable alternate vehicle that you can use? *

If you sign a contract with The Union, you are agreeing to be responsible for delivery to subscribers on the route seven days a week. However, you are not required to personally do this every day, you have the right to choose others to assist and/or substitute for you. Are you willing to and can you fulfill this obligation? *