New Starters Form

PERSONAL DETAILS Please complete form carefully and in block capitals

TITLE i.e. Mr, Mrs, Miss etc

SURNAME

FORENAME

KNOWN AS

Home Name/Work Location

Transferred From (if applicable)

JOB TITLE
PERSONAL ADDRESS
POST CODE
HOME TELEPHONE NO.

MOBILE TELEPHONE NO.

NATIONAL INSURANCE NO.

DATE OF BIRTH

NMC PIN NO. (if applicable)

NATIONALITY

EMAIL ADDRESS

NEXT OF KIN / 1st EMERGENCY CONTACT

FULL NAME

RELATIONSHIP TO YOU
i.e. husband, mother, etc

ADDRESS
POST CODE
1st CONTACT NO.
nd

2nd CONTACT NO.

EMERGENCY CONTACT

FULL NAME

RELATIONSHIP TO YOU
i.e. husband, mother, etc

ADDRESS
POST CODE
1st CONTACT NO.

2nd CONTACT NO.

BANK OR BUILDING SOCIETY DETAILS

I confirm I wish my earnings to be paid in to the bank or building society account detailed below.
BANK OR BUILDING SOCIETY
NAME
ADDRESS

POST CODE

ACCOUNT PAYEES NAME

BANK SORT CODE

BUILDING SOCIETY REF. NO.

Bank Account No.

P45/P46 Section Please Complete in Full

P45 Attached, please tick ()

YES

NO

STUDENT LOAN
I have not fully repaid my Student Loan, please tick ()
(if you are required to repay your Student Loan through your
bank or building society accounts do not tick)

Please read the following statements and tick () the box that applies. If unsure, please ask your Administrator.

This is my first job since last 6th April and I have not been receiving taxable Jobseekers
Allowance or taxable Incapacity Benefit or a state or occupational pension.

This is now my only job, but since last 6th April I have had another job, or have received taxable
Jobseekers Allowance or Incapacity Benefit. I do not receive a state or occupational pension.

I have another job or receive a state or occupational pension.

SIGNATURE OF EMPLOYEE _____________________________________________________ DATE _________________

ADMINISTRATOR TO COMPLETE THIS SECTION:
Start Date
Payroll Number
Contracted Hrs

Fixed Days/Shifts

Leave Entitlement
Hourly Rate/Salary

AUTHORISED BY (Gen Manager)________________________________________________ DATE _________________

Note: Put a copy of this form into the employees personal file and send this original to Payroll immediately
New Starters Form