Independent Contractor Agreement

Standard 1099 contractor agreement with IP assignment.

BTL-PBL-04.006

Form

Vol 04 — Legal, Risk & Compliance

Contractor

Legal name *

Business name (if any)

Address *

Email *

Phone

W-9 on file

Yes / N/A

COI on file

Yes / N/A

Role / services *

Effective date *

End date (if any)

Compensation & payment schedule *

Expense reimbursement

IP assignment acknowledged *

Yes / N/A

Contractor signature *

Date *

BTL authorized signature *

Date *

Controlled document — BTL-PBL-04.006. Complete all required fields (marked *). Retain per Volume 15 retention schedule.