HM Revenue & Customs Starter checklist Instructions for employers This Starter Checst canbe used to gather information about your new employee. You cn use this information to help fillin your frst Full Payment Submision (FS) fortis employee. You need to keep the information recorded on the Starter Checks record forthe current and previous 3 tax years Do not send this form to HMRC Instructions for employees ‘As anew employee your employer needs the infermation on this form before your ist payday to tll HMRC about you and ep ther ue the cotect ax cod. Fl nti form then give to your employe. Donat send tis form to HAC Employee's personal details 1) Lastname 5! Home address 2) First name(s) Do not enter initials or shortened names such asim for James or iz For Blzabeth 65 National insurance number (f known “| : i ll 3) Are you mate or female? 7, Employment start date 0D MM VY ,- 7 mate Female 4 Date of birth D0 AIM YYYY Employee statement 8 You need to select only one of the Following statements A, Bar C id ‘This is my fst Job since 6 Apri an fve not been receiving ravable Jobseekers Alowance, Employment and Support Alowanve, taxable Incapacity Benefit State oF Occupational Pension. : ‘This s now my only job but since 6 April Tve had another jb, or receved taxable Jobseoker's Allowance, Employmen: and Suppart Allowance or taxable incapacity Benet. 1 60 not receve a State ar Occupational Pension, ‘As well as my new jt, | have another job o receive a State or Occupational Pension, Please turn over > Starter checks Page! Hane 02/19Student Loan For more guidance about repaying go to ‘wn govuk/repaying-your-studentioan Dp you have one ofthe Student Loan Plans described Ca below which isnot fully repaid? Yes IF Yes. goto question 19, No IFN. go to question 13, Did you complete or leave your studies before sth Apri yes | Irves.go te question 11 No No, go to question 13 ‘Are you repaying your Student Loan directly to the ‘Student Loans Company by direct debit? Yes Fes go to question 13 No IF No, go to question 12 ‘what eype of Student Loan do you have? Punt Plan 2 Bath Student Loan Plans Youll have a Plan 1 Student Loan if: + you lived in Scotland or Northern ireland when you started ‘your course (undergraduate or postaraduate) + you lived in England or Wales and started your indergraduate course before 1 September 2012 You'l have a Plan 2 Student Loan if: + you lived in England or Wates and started your Undergraduate course on or after 1 September 2912 + your loan is aPart Time Maintenance Loan + your laan isan Advanced Learner Loan + your loan sa Postgraduate Healthcare Loan Postgraduate Loan For more guidance about funding and repaying go to vrongoualitandngforpostraduatestidy For mare guidance fr emplayers goto su govalguldancelspedabrutsfocstdentoans 13) Bo you have a Postgraduate Loan which is not fully repaic? Yes. Yes go to question 14 No | No. gota the Declaration YoulU have a Postgraduate Loan if + you lived in England and started your Postgraduate Master's ‘outse on or after 1 August 2018 + you lived in Wales and started your Postgraduate Masters ‘course on or after 1 August 2017 + you lived in England or Wales and started your Postgraduate Doctoral caurse on or after 1 August 2018 |W Did you complete or leave your Postyraduate studies ‘before 6th Apritr Yes ves go ta question 15 No HfNo, goto the Dedaration (1S! are you repaying your Postgraduate Loan direct tothe Student Loans Company by direct debit? No Goto the Declaration Declaration | confirm that the information fve given on this form is corre Signature ct Full ame Date 00 Mi ey Page?