Payroll Form | Alliance for Better Care

Employee Personal Details

Name *

First

Last

Previous Surname

Gender *

Male
Female
Non-binary
I do not wish to disclose

Date of Birth *

NI Number *

Telephone Number *

Mobile Number *

Email *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Next of kin – name *

Next of kin – mob number *

Next of kin – relationship *

Please choose from the following *

This is my first job since 6 April 2023 and I have not been receiving taxable Jobseeker’s Allowance or taxable Incapacity Benefit or a state or occupational pension
From my start date with ABC this will be my only job, but since 6 April 2023 I have had another job, or have received taxable Jobseeker’s Allowance or taxable Incapacity Benefit. I do not receive a state or occupational pension
I have another job or receive a state or occupational pension.

______________________

Student Loans

Do you have a Student Loan? *

Do you have a Postgraduate Loan? *

______________________

Bank Details

Account type *

Bank
B/Soc.
Other

Account no (8 digits) *

Sort Code *

Name on account *

Building soc no

Bank name *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

______________________

NHS Pension Scheme

Please ensure you read the Guide to the NHS Pension Scheme before answering these questions.

Are you currently claiming any NHS Pension Scheme retirement benefits from any of the following : 1995, 2008 or 2015 sections? *

Do you wish to opt out of the NHS Pension Scheme? (If no, please also complete questions in the next section) *

Your signature *

Date *

This form will be emailed to the People Services team upon completion

______________________

NHS Pension Scheme New Employee Checklist

To be completed if the employee IS NOT OPTING OUT of the NHS Pension Scheme.

Please study the list carefully – ALL FIELDS MUST BE COMPLETED. Please refer to the Scheme Guide if you are unsure about any of these points. You can obtain a Scheme Guide from you’re the People Services Team or from the NHS Pensions Website. http://www.nhsbsa.nhs.uk/pensions

In the twelve months preceding this post, was your hourly rate higher whilst being an active member of the NHS Pension Scheme? (If YES – In certain circumstances it may be possible to protect an employee's pension benefits at a higher rate of pay where a reduction in pay has occurred. This will only be applicable if you have 1995 or 2008 membership. Please provide your Manager with any relevant details or information.) *

Will you continue to be employed elsewhere in the NHS (Inc. Bank or Out of Hours Provider work), and paying NHS pension contributions once you have commenced your position with ABC? Concurrent part-time membership is allowable but only up to whole-time hours. Please provide details to your Manager if applicable. *

Are you currently making contributions to Added Years (1995 members only) *

Are you currently making contributions to the Early Retirement Reduction Buy Out (ERRBO) (2015 members only) *

Are you currently making contributions to the Half Cost Added Years (1995 members only) due to a refund of contributions for any NHS membership before 05/04/1978 *

Are you currently making contributions to the Additional Pension (All members) *

Do you have any previous pension arrangements that you are considering transferring into the NHS Pension Scheme? This includes NHS Scotland & Northern Ireland. There are time limits on transferring benefits from any pension scheme outside the NHS (internal transfers are not constrained by time limits e.g. Scotland to England and Wales). For members of the 1995 section – within 12 months from joining. For members of the 2008 section – within 12 months from becoming eligible to join. For members of the 2015 section – within 12 months from becoming eligible to join and before your Normal Pension Age which is equal to your State Pension Age or 65 if that is later. *

Do you have a non-legal partner (co-habitee)? For a non-legal partner to benefit from Survivor Benefits form PN1 MUST be completed. The Scheme provides a pension for legally married couples & civil partnerships. Certain qualification criteria must be met for Survivor pensions for co-habitees. Ask the People Services Team for a form PN1 or download from website www.nhsbsa.nhs.uk/pensions The completed form should be forwarded to NHS Pensions. *

Do you wish to nominate someone other than your spouse or civil partner to receive your life assurance lump sum? A lump sum equal to twice a member’s annual pensionable pay is due to a surviving spouse or civil partner, or if a member is single, widowed or divorced, it will form part of their estate. By requesting or downloading form DB2, payment may be made to either one or more nominated individuals, an organisation or a Personal Legal Representative. The completed form should be forwarded to NHS Pensions. *