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Example form of a written statement of employment particulars

URN No: 07/1102

This is an example of a possible form of a written statement of employment particulars meeting the requirements of employment legislation.

For a detailed explanation of these requirements see: Written statement of employment particulars - Guidance.The written statement may be provided either:

a) as a single document;

or

b) in a number of instalments - provided that certain details, dealt with in paras 1-8 , are always given together in the same instalment.

All instalments must be given to the employee not later than two months after he/she starts work or if, at an earlier stage he/she is required to work outside the UK for more than one month, not later than his/ her departure.

Unless otherwise indicated, all particulars must be set out in the statement itself and not be given by reference to: a collective agreement; a handbook; or any other document which does not form part of the written statement.

Lengthy or complicated particulars may be given on a continuation sheet or via an attached booklet or other annex - provided it is clear that this is integral to the statement, or the relevant instalment of it, and forms part of the same document.

Where there are no particulars to be given for paras 1-14 , the statement must say so in each case.

Some of the separate stages in paras 15-21 may be combined where, for example:

a) the same person is the first to be approached for appeals against disciplinary or dismissal decisions and for grievances;

or

b) the method of application in both cases is the same.

Explanatory notes for completion are given in the right hand column on each page.

Note: Some terms and conditions of employment are subject to statutory requirements, eg rates of pay, working hours and holidays, notice of termination of employment and disciplinary and grievance procedures. For information please see: A detailed guide to the national minimum wage, Your guide to the Working Time Regulations, Rights to notice and reason for dismissal and the Resolving disputes web page.

_____________________________________________________________________________________________

 

Written Statement of employment particularsNotes for completion of form


Insert:
P1YouP1:

1 Name of employee

began employment with

2 Name of employer

on

3 Date employment started



P2*a. Your previous employment withP2:*delete (a) or (b) as appropriate

4 Name of previous employer or employers

does count as part of your period of continuous employment which therefore began on

5 Date period of continuous employment commenced
or


*b. Your previous employment does not count as part of your period of continuous employment



P3a. You are employed asP3:(complete (a) or (b), delete the other)

6 Job title
or
or

b. A brief description of the work for which you are employed is:

7 Brief work description



P4a. Your place of work isP4:(complete (a) or (b), delete the other)

8 Address of workplace

b. You are *required/permitted to work at the following placesor *delete as appropriate

9 Give details

and the address of your employer is

10 Address of employer



P5Your pay will beP5:

11 Particulars of scale or rate of renumeration, or of the method of calculating remuneration



P6You will be paidP6:

12 Particulars of intervals at which remuneration is to be paid



P7Your hours of work areP7:

13 Particulars (see note above) - including details of any normal working hours



P8Your holiday entitlement isP8:

14 Particulars (see note above) - including entitlement to holiday pay and public holidays. You must give enough information to enable entitlement, including accrued holiday pay on termination, to be precisely calculated.



P9a. In case of incapacity to workP9:(complete (a) or (b), delete the other)

15 Terms and conditions relating to sickness or injury and any provision for sick pay
orb. Particulars of any terms and conditions relating to incapacity to work due to sickness or injury, including any provision for sick pay, can be found inor

16 Refer to provisions of some other document which the employee has reasonable opportunities of reading in the course of his or her employment or which is made reasonably accessible to him or her in some other way



P10a. Particulars of pensions and pension schemes areP10:(complete (a) or (b), delete the other)

17 Particulars
orb. Particulars of terms and conditions relating to pensions and pension schemes, can be found inor

18 Refer to provisions of some other document which the employee has reasonable opportunities of reading in the course of his or her employment or which is made reasonably accessible to him or her in some other way



P11a. The amount of notice of termination of your employment you are entitled to receive isP11:(complete (a) or (b), delete the other)

19 Period of notice

The amount of notice you are required to give is

20 Period of notice
orb. Particulars of the amount of notice of termination of your employment you are entitled to receive and are required to give are given inor

21 Refer to relevant legislation or the provisions of any collective agreement directly affecting the terms and conditions of the employment, which the employee has reasonable opportunities of reading in the course of his or her employment or which is made reasonably accessible to him or her in some other way



P12a. Your employment is permanent - subject to 11 above, to general rights of termination under the law and to the followingP12:(complete (a) or (b), delete the other)

22 Details of any other rights of termination
orb. Your employment is for a fixed term and expires onor

23 Date
orc. Your employment is temporary and is expected to continue foror

24 Period of likely duration
This should only be used as an indication of the likely duration



P13The collective agreements which directly affect the terms and conditions of your employment areP13:

25 Details identifying the relevant agreements and indicating, where the employer is not a party, the persons by whom they were made



P14*a. You are not expected to work outside the UK (for more than one month)P14:*delete (a) or (b) as appropriate
26 Delete words in brackets if they are inappropriate
or*b. You will be required to work inor

27 Details of work location outside the UK

for 28 Period of work outside UK, where more than one month

You will be paid in 29 Currency

and will be entitled to

30 Details of any additional remuneration payable to the employee, and any benefits to be provided, because he/she is required to work outside the UK

The terms relating to your return to the UK are

31 Details



P15a. The disciplinary rules which apply to you areP15:(complete (a) or (b), delete the other)

32 An explanation of the rules
orb. The disciplinary rules which apply to you can be found inor

33 Refer to provisions of some other document which the employee has reasonable opportunities of reading in the course of his or her employment or which is made reasonably accessible to him or her in some other way
  

 

P16(for completion from 1 October 2004)P16:(complete (a) or (b), delete the other)

a. The disciplinary and dismissal procedure which applies to you is 
 34 An explanation of the procedure
orb. The disciplinary and dismissal procedure which applies to you can be found in:or
 35 Refer to provisions of some other document which the employee has reasonable opportunities of reading in the course of his or her employment or which is made reasonably accessible to him or her in some other way
  

 

P17If you are dissatisfied with any disciplinary (or, from 1 October 2004, dismissal) decision which affects you, you should apply in the first instance toP17:

36 Name of person application should be made to, or position held (eg supervisor)



P18You should make your application byP18:

37 Explain how applications should be made



P19If you have a grievance about your employment you should apply in the first instance toP19:

38 Name of person grievance should be raised with, or position held (eg personnel officer)



P20You should make your application byP20:

39 Explain how grievances are to be raised



P21a. Subsequent steps in the firm's disciplinary (and from 1 October 2004, dismissal) and grievance procedures areP21:(complete (a) or (b), delete the other)

40 An explanation of the steps
orb. Subsequent steps in the firm's disciplinary and grievance procedures are set out inor

41 Refer to provisions of some other document which the employee has reasonable opportunities of reading in the course of his or her employment or which is made reasonably accessible to him or her in some other way



P22A contracting-out certificate under the Pensions Schemes Act 1993 *is/is not in force for the employment this statement is being issued for

*delete as appropriate

42 For further information contracting out certificates, call 019122501501