## Notice Of Penalty Determination

Year ended 5 April 9999 
REPRINT_REFERENCEXXX
RECIPIENT_NAME_LINE_1_MAX_35_CHARSX RECIPIENT_NAME_LINE_2_MAX_35_CHARSX
ADDRESS_LINE_1_MAX_35_CHARSXXXXXXXX ADDRESS_LINE_2_MAX_35_CHARSXXXXXXXX ADDRESS_LINE_3_MAX_35_CHARSXXXXXXXX ADDRESS_LINE_4_MAX_35_CHARSXXXXXXXX ADDRESS_LINE_5_MAX_35_CHARSXXXXXXXX POSTCODE
Issued by OFFICER_IN_CHARGEXXXXXXXXXXXXXXXXXX
OFFICE_NAME_MAX_35_CHARSXXXXXXXXXXX OFFICE_ADDRESS_LINE_1_MAX_35_CHARSX OFFICE_ADDRESS_LINE_2_MAX_35_CHARSX
OFFICE_ADDRESS_LINE_3_MAX_35_CHARSX OFFICE_ADDRESS_LINE_4_MAX_35_CHARSX OFFICE_ADDRESS_LINE_5_MAX_35_CHARSX POSTCODE
This is not the address for payments. See overleaf.

Phone
08457 143 143
Fax 99999999999999999999 Date of issue 99 Monthxxxx 9999
Penalty number
999/999/9/999999/99/9999999999
Amount payable
£99999.99
About this notice You are required by law to send starter and leaver forms, P45 (Part 1), P45 (Part 3), P46, P46(Pen) and P46(Expat), to us online; via the Internet or Electronic Data Interchange (EDI). As you have not sent all of your starter and leaver forms to us online you are now liable to a penalty. This notice gives details of that penalty. If you have an agent or professional adviser you should show them this notice immediately. If you do not understand why you have received this notice please ask me about it. My details are shown above.

How the penalties are worked out We have worked out your penalty based on the number of paper starter and leaver forms that you sent us during the quarter ended 5 Monthxxxx 9999; the table overleaf gives more details. Based on that figure, your penalty is £99999.99.

Payment You should pay the amount shown on or before  99 Monthxxxx 9999, using the payslip below. The notes overleaf give more information about *Paying HMRC*.

ECS394(B)(einyr)
M Please detach payslip here M
HMRC 07/09
Penalties for not filing starter and leaver forms online We send you a penalty notice when you do not file your starter and leaver forms online. 

The amount of penalty we charge is based on the number of paper forms that you send us. The table below gives details.

Penalty
(£)
Number of paper starter 
and leaver forms included 
in the quarter
1–5
0
6–49
100
50–149
300
150–299
600
300–399
900
400–499
1,200
500–599
1,500

Appeals If you want to appeal you should write to us within 30 days of the date the original Notice of Penalty Determination was issued, stating the grounds for the appeal. If you think you have a reasonable excuse for failing to send your starter and leaver forms online, please explain this. If you think there are good reasons to reduce the penalty amount please say why. We will, if possible, try to settle your appeal by agreement with you. If we cannot do this, we will write and tell you why and offer you a review by a person not previously involved in your appeal. We will also tell you about your right to appeal to an independent tribunal. For more information about *review* and *appeals*, go to www.hmrc.gov.uk or ask us for our factsheet HMRC1.

| 600–699       | 1,800   |
|---------------|---------|
| 700–799       | 2,100   |
| 800–899       | 2,400   |
| 900–999       | 2,700   |
| 1,000 or more | 3,000   |

Print How to pay here, 
coordinates for top left 
corner
X = 11mm
Y = 87mm