IM Revenue & Customs Starter checklist Instructions for employers This Starter Checklist can be used to gather information about your new employee. You can use this information to help fin your firs Fail Payment Submission (FPS) for thisemployee. You need to keeo the information recorded an the Slaces Checklist record forthe current and previous 3 ta years ‘bo nat send this form to HMRC Instructions for employees Zs a newemployee your employer needs the nfermstion on this farm belors your fst payday t tll HMRC boul youd help them use the correct tax code. Fil in this form then give it to your employer Do not send this farm ta HMRC Employee's personal details Tl tae nies Alc Oanide dt Hok GON 1K WG SSH AE Rel King (Land Lodi 2) Fist names) Reteirpties etentemmhtty OE UAE QauNS_AR aN UNcTE AING DOM, a | racist norma nate eines) ee aid Se) W3 Wi 0 rte OS reat 3) Employment start date DD-AUAYYYY 7) Date of arth OD MALTY alr] oly [alelalt i] fos! ig Employee statement 1) You need to select only one of the following statements A, Bor C A [{_Thtits since hand ve ot tenes aa oben Aone Emplayment and Support Allowance, taxable Incapacity Benefi, State or Occupational Pension. “hic now my only job burt since 6 April we had another job, oF recived taxable Jobeaeker's Allowance, Employment and Support Allawance or taxable Incapacity Benefit. {donot receive 2 State ax Occupational Pension Ac well ry ney jb. awe anather job oF reccue = Stale ar Becupational Pension Please tum over > Startcs cheek Page | urc ons