Please complete all sections in CAPITAL LETTERS and return to us with

CIS Registration Form

your signature.

Your Personal Details

Profession ............................................. Home Address .............................................
Gender ............................................. .............................................
Title ............................................. .............................................
First Name ............................................. Post Code .............................................
Other Names ............................................. Email Address .............................................
Surname ............................................. Marital Status .............................................
Date of Birth ............................................. Place of Birth .............................................
Mobile Number ............................................. Nationality (on your passport) .........................
Home Telephone Number ............................................. VAT Number ....
NI Number ............................................. (Please enclose your VAT certificate if applicable.)
UTR Number ............................................. How Did You Hear About Us?...........................
.
Your Agency / Client Details
Branch Location .............................................
Agency Name ............................................. Branch Phone Number......................................
Consultant Name ............................................. Start date of current assignment......................
Consultant Email ............................................. End date of current assignment........................
Rate Per Hour/ Day .............................................

Bank Account Details

Account Number.............................................
Bank Name .............................................
Sort Code ................................................
Branch Location .............................................
Building Society Reference..............................
Name of Account .............................................

DECLARATION AND SIGNATURES

I have received, read and understood and agree to accept the terms and conditions of contract provided to me by Thornberry UK
and have signed and returned them with this application form, as well as any corresponding policy and procedures.

I agree to a self-billing procedure with Thornberry UK the company and myself the supplier for the duration of the contract. I
confirm that for the duration of the contract I will not raise sales invoices, I will accept invoices raised on my behalf by the customer
and I will notify any changes to the suppliers circumstances, including if the supplier ceases to be VAT registered or if the supplier
changes their registration number.

I certify that the above details are complete and correct and that Thornberry UK shall have the right to terminate my contract of
employment should it become clear that any information provided is untrue or misleading.

I confirm that I consent to CPS Ltd using my personal information, including sensitive personal data in accordance with
Signed ..............................................................................................

Dated ..............................................................................................