ATN Partnership

142-143 Parrock Street, Gravesend, Kent, DA12 1EY

Tel: 01474 326224 Fax: 01474 326225 e-mail: info@atnpartnership.co.uk

NEW EMPLOYEE FORM

Company/Employer Name: Da Streams ltd

Title Mr
Surname Ehiglator
Forename Adam’s Efosa
Address 49 Elcot Avenue London

Postcode SE15 1QB

Male/Female Male Date of Birth 19-12-1970

Marital Status Single NI Number SX656609B

Starting date Nationality Nederland

Job Title

Hourly rate/monthly salary

Hours worked per week (if applicable)

Do you have a Student Loan: No

Which statement below applies to you?

1. This is my first job since last 6 April and I have not been receiving taxable Jobseeker's
Allowance, Employment and Support Allowance or taxable Incapacity Benefit or a state or occupational
pension.
2. This is now my only job, but since last 6 April I have had another job, or have received taxable
Jobseeker's Allowance, Employment and Support Allowance or taxable Incapacity Benefit. I do not
receive a state or occupational pension.
3. I have another job or receive a state or occupational pension.