New Starter Checklist

Please note this section is for new starters only to complete on their first day of employment

Clock Card Number*

Factory/Dept*

Section*

First name(s)*

Last name or family name*

Are you male or female?*

Date of birth dd/mm/yyyy

Address*

Town*

Postcode*

Home telephone Number*

Mobile telephone number

Email address*

National Insurance Number*

Employment start date dd/mm/yyyy*

Bank name*

Name of account holder*

Sort code*

Account number*

Rate of pay p/h*

Please select only one of the following statements*

This is my first job since last 6 April and I have not been receiving taxable Jobseeker’s Allowance, Employment and Support Allowance, taxable Incapacity Benefit, State or Occupational Pension. This is now my only job but since last 6 April I have had another job, or received taxable Jobseeker’s Allowance, Employment and Support Allowance or taxable Incapacity Benefit. I do not receive a State or Occupational Pension. As well as my new, I have another job or receive a State or Occupational Pension.

I have a Student Loan which is not fully repaid and I left a course of UK higher education before last 6 April andreceived my first Student Loan instalment on or after 1 September 1998.

Select ‘No’ if you are repaying your Student Loan direct to the Student Loans Company by agreed monthly payments.

Student Loan*

Yes No N/A

Contact 1 Name*

Contact 1 Number*

Contact 1 Email Address

Contact 2 Name*

Contact 2 Number*

Contact 2 Email Address

Full name*

Date dd/mm/yyyy*