Form PW1
About you
Q1. Title
Options: Mr; Mrs; Miss; Ms; other
About you
Q2. First name
About you
Q3. Middle name, if you have any
About you
Q4. Last name
About you
Q5. Address
About you
Q6. Date of birth
Guidance: DD/MM/YYYY
About you
Q7. A phone number we can contact you on
About you
Q8. Email address
Guidance: If you have one.
About you
Q9. National Insurance (N I) number
About the work you are starting or have started
Q10. Is your work self-employed?
Options: No; Yes
About the work you are starting or have started
Q11. Employer or company name
About the work you are starting or have started
Q12. Employer or company address
About the work you are starting or have started
Q13. Job title
About the work you are starting or have started
Q14. Tell us what you do at work
About the work you are starting or have started
Q15. On what date did you start work or will you start work?
Guidance: If this date changes please tell us.
About the work you are starting or have started
Q16. How much will you earn after tax?
Guidance: This is the amount after income tax and National Insurance (NI) contributions are taken off.
About the work you are starting or have started
Q17. Do you get any of the following? If so, tell us about them:
Options: earnings or fees as a director; maternity pay; holiday pay; bonus payments; Statutory Adoption Pay (SAP); Statutory Maternity Pay (SMP); Statutory Paternity Pay (SPP); Statutory Sick Pay (SSP)
Guidance: By expenses we mean any money that is not part of your wage.
About the work you are starting or have started
Q18. How many hours will you work each week?
Guidance: If your hours will be different each week, please tell us as much as you can about your working pattern.
About the work you are starting or have started
Q19. If your hours will be different each week, please tell us as much as you can about your working pattern
About the work you are starting or have started
Q20. When will you get your first payment?
About the work you are starting or have started
Q21. Will you get any expenses?
Options: No; Yes
Guidance: By expenses we mean any money that is not part of your wage.
About the work you are starting or have started
Q22. Are you sending your first payslip, bank statements or accounts with this form?
Options: No; Yes
Supported permitted work
Q23. Title
Options: Mr; Mrs; Miss; Ms; other
Supported permitted work
Q24. First name
Supported permitted work
Q25. Middle name, if you have any
Supported permitted work
Q26. Last name
Supported permitted work
Q27. Official address
Supported permitted work
Q28. Organisation’s stamp
Supported permitted work
Q29. Their phone number
Supported permitted work
Q30. Support worker’s signature
Supported permitted work
Q31. Date
Declaration
Q32. Your signature
Guidance: You must sign this form yourself if you can, even if someone else has filled it in for you.
Declaration
Q33. Date of signature
About you
Q1. Title
Options: Mr; Mrs; Miss; Ms; other
About you
Q2. First name
About you
Q3. Middle name, if you have any
About you
Q4. Last name
About you
Q5. Address
About you
Q6. Date of birth
Guidance: DD/MM/YYYY
About you
Q7. A phone number we can contact you on
About you
Q8. Email address
Guidance: If you have one.
About you
Q9. National Insurance (N I) number
About the work you are starting or have started
Q10. Is your work self-employed?
Options: No; Yes
About the work you are starting or have started
Q11. Employer or company name
About the work you are starting or have started
Q12. Employer or company address
About the work you are starting or have started
Q13. Job title
About the work you are starting or have started
Q14. Tell us what you do at work
About the work you are starting or have started
Q15. On what date did you start work or will you start work?
Guidance: If this date changes please tell us.
About the work you are starting or have started
Q16. How much will you earn after tax?
Guidance: This is the amount after income tax and National Insurance (NI) contributions are taken off.
About the work you are starting or have started
Q17. Do you get any of the following? If so, tell us about them:
Options: earnings or fees as a director; maternity pay; holiday pay; bonus payments; Statutory Adoption Pay (SAP); Statutory Maternity Pay (SMP); Statutory Paternity Pay (SPP); Statutory Sick Pay (SSP)
Guidance: By expenses we mean any money that is not part of your wage.
About the work you are starting or have started
Q18. How many hours will you work each week?
Guidance: If your hours will be different each week, please tell us as much as you can about your working pattern.
About the work you are starting or have started
Q19. If your hours will be different each week, please tell us as much as you can about your working pattern
About the work you are starting or have started
Q20. When will you get your first payment?
About the work you are starting or have started
Q21. Will you get any expenses?
Options: No; Yes
Guidance: By expenses we mean any money that is not part of your wage.
About the work you are starting or have started
Q22. Are you sending your first payslip, bank statements or accounts with this form?
Options: No; Yes
Supported permitted work
Q23. Title
Options: Mr; Mrs; Miss; Ms; other
Supported permitted work
Q24. First name
Supported permitted work
Q25. Middle name, if you have any
Supported permitted work
Q26. Last name
Supported permitted work
Q27. Official address
Supported permitted work
Q28. Organisation’s stamp
Supported permitted work
Q29. Their phone number
Supported permitted work
Q30. Support worker’s signature
Supported permitted work
Q31. Date
Declaration
Q32. Your signature
Guidance: You must sign this form yourself if you can, even if someone else has filled it in for you.
Declaration
Q33. Date of signature