Employee Statement

Please select one of the following statements A, B or C.

A. DO NOT CHOOSE THIS STATEMENT IF YOU’RE IN RECEIPT OF STATE, WORKS OR PRIVATE PENSION. CHOOSE THIS STATEMENT IF THE FOLLOWING APPLIES. THIS IS MY FIRST JOB SINCE 6 APRIL AND SINCE 6 APRIL I’VE NOT RECEIVED PAYMENTS FROM ANY OF THE FOLLOWING: JOBSEEKER’S ALLOWANCE, EMPLOYMENT AND SUPPORT ALLOWANCE OR INCAPACITY BENEFIT.

Choose ths Option

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B. DO NOT CHOOSE THIS STATEMENT IF YOU’RE IN RECEIPT OF STATE, WORKS OR PRIVATE PENSION. CHOOSE THIS STATEMENT IF THE FOLLOWING APPLIES. SINCE 6 APRIL I HAVE HAD ANOTHER JOB BUT I DO NOT HAVE A P45. AND/ OR SINCE 6 APRIL I HAVE RECEIVED PAYMENTS FROM ANY OF THE FOLLOWING: JOBSEEKER’S ALLOWANCE, EMPLOYMENT AND SUPPORT ALLOWANCE OR INCAPACITY BENEFIT

Choose this Option

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C. CHOOSE THIS STATEMENT IF: YOU HAVE ANOTHER JOB AND/OR YOU’RE IN RECEIPT OF STATE, WORKS OR PRIVATE PENSION.

Choose this Option

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Student Loan *

I HAVE A STUDENT LOAN WHICH IS NOT FULLY REPAID AND I LEFT A COURSE OF UK HIGHER EDUCATION BEFORE LAST 6 APRIL AND I RECEIVED MY FIRST STUDENT LOAN INSTALMENT ON OR AFTER 1 SEPTEMBER 1998. SELECT 'NO' IF YOU ARE REPAYING YOUR STUDENT LOAN DIRECT TO THE STUDENT LOANS COMPANY BY AGREED MONTHLY PAYMENTS.

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Name *

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