Private and Confidential
VAM Payroll
DETAILS OF ENGAGEMENT – FOR COMPLETION BY DEPARTMENT
Department
Departmental
Contact
Telephone
Number
SECTION A
PLEASE NOTE ALL SECTIONS OF THIS FORM MUST BE COMPLETED – all sections of the form must be sent together
Candidate Name
Surname (as official documents)
Forename (s) (as official documents)
Start date
of Work
note: the start date cannot be earlier than the Evidence of right to work
form check date
D
D
M
M
Y
Y
Please note: the start date cannot be earlier than the date right to worked is checked
Please tick one of the following statements
This individual will carry out work that is academic in nature. This includes any teaching,
research, marking, demonstrating, invigilation, etc.
97
This individual will carry out work that is non-academic at FA level 5 and above
Professional Fee post
eligible to be considered for USS
97 Professional Fee post
eligible to be considered for USS
This individual will not be undertaking any academic work and will solely be paid at
FA level 4, or below (i.e. payment rate will be less than £13.05 per hour)
98
Casual post – eligible to be
considered for UPS
SECTION B
Please complete evidence of right to work section and provide copies of evidence of right to work in the UK, all copies must be signed, dated
and marked as original seen. Failure to do this will result in the form being return to the originating department. Please look at check list
below to ensure all required documents are attached with this form.
Evidence of
Right to work form
Copies of right
to work documents
Tier 4 student
declaration
(for any Tier 4 student visa holder)
HESA information
Tier 2 or 5
Supplementary form
Required when working under supplementary rules for T2 or T5 GAE visa holders
http://www2.warwick.ac.uk/services/humanresources/payroll/payrollforms/vam/
I confirm that the above appointment information is accurate, all right to work documents have been checked prior to commencement of
any work and that the appropriate documents are attached to this form. Form verified as complete and accurate.
Signed
Print Name
Date
May 2016
Private and Confidential
VAM Payroll
EVIDENCE OF RIGHT TO WORK - FOR COMPLETION BY DEPARTMENT
University of Warwick – Prevention of Illegal working (from 29 February 2008) Immigration, Asylum and Nationality Act 2006.
This form must be completed for ALL offers of work.
Candidate Name
Surname (as official documents)
Forename (s) (as official documents)
Please indicate on the attached pages exactly which original documents have been presented.
Details of identification checker
Name
Position
Dept.
Tel No
Signature
Date
The Evidence of right to work must be signed and copies of right to work documents must be signed, dated and marked as original seen.
IMPORTANT - Please note this must be prior to the commencement of any work.
Is the work going to be undertaken in the UK
YES
NO
If no please specify where the work will be undertaken and provide evidence of right to work in that country (e.g. copy of a passport
Showing the individual is a national of that country)
Country of work
I confirm I have seen the original documents indicated prior to the commencement of any work and that to the best of my knowledge:

they relate to the candidate named above

any photo ID seems to match the physical identity of the candidate named above

names and dates of birth are consistent across documents

the original documents show no obvious signs of tampering or forgery

the relevant visa has been checked and copies attached

I have read the immigration information on the HR website re student tier 4 working hours
(http://go/hr/newpolicies/student_workers)
Does this individual have a Tier 4 student Visa? Please tick the appropriate box: - Yes
No
If yes please complete the following:
Undergraduate
Restricted to 20 hours work per week in term time, no restrictions on working hours in vacation.
Undergraduate students must provide evidence of the dates of the academic terms for the duration of their
studies for the period they intend to work
Masters
PhD
Completed Studies
Restricted to 20 hours work per week
Restricted to 20 hours work per week
Official confirmation of degree pass required – no restriction on working hours
The student must present either the original degree certificate or an official letter from the Graduate School
which contains the wording 'officially conferred by Senate'
Tier 4 students must complete a student declaration form (refer to the last page of this form) confirming that they are employed under Tier 4
regulations, otherwise paperwork will be returned to the department.
If you have any queries on this documentation please contact either your link HR Administrator or Julia Foulks, HR Officer – Immigration on
ext. 73161 or e-mail J.Foulks@warwick.ac.uk
Please indicate in one box from List A or List B to confirm which original document or combination of documents have been presented.
If any work is undertaken by a migrant worker under Tier 2 supplementary employment rules, please refer to the Tier 2 supplementary form
on the payroll web pages. Attach the form and a copy of the Tier 2 visa to the Evidence of Right to Work Renewal form which is located at
http://www2.warwick.ac.uk/services/humanresources/payroll/payrollforms/vam/
May 2016
Private and Confidential
VAM Payroll
Please note that you need to check the validity of the document and satisfy yourself that the prospective or existing worker is the person
named in the documents they present.
List A
1. A passport showing the holder, or a person named in the passport as the child of the holder, is a British citizen or a citizen of the UK and Colonies having the
right of abode in the UK.
2. A passport or national identity card showing the holder, or a person named in the passport as the child of the holder, is a national of a European Economic
Area country or Switzerland.
3. A Registration Certificate or Document Certifying Permanent Residence issued by the Home Office to a national of a European Economic Area country or
Switzerland.
4. A Permanent Residence Card issued by the Home Office, to the family member of a national of a European Economic Area country or Switzerland.
5. A current Biometric Immigration Document (Biometric Residence Permit) issued by the Home Office to the holder indicating that the person named is
allowed to stay indefinitely in the UK, or has no time limit on their stay in the UK.
6. A current passport endorsed to show that the holder is exempt from immigration control, is allowed to stay indefinitely in the UK, has the right of abode in
the UK, or has no time limit on their stay in the UK.
7. A current Immigration Status Document issued by the Home Office to the holder with an endorsement indicating that the named person is allowed to stay
indefinitely in the UK or has no time limit on their stay in the UK, together with an official document giving the person’s permanent National Insurance number
and their name issued by a Government agency or a previous employer.
8. A full birth or adoption certificate issued in the UK which includes the name(s) of at least one of the holder’s parents or adoptive parents, together with an
official document giving the person’s permanent National Insurance number and their name issued by a Government agency or a previous employer.
9. A birth or adoption certificate issued in the Channel Islands, the Isle of Man or Ireland, together with an official document giving the person’s permanent
National Insurance number and their name issued by a Government agency or a previous employer.
10. A certificate of registration or naturalisation as a British citizen, together with an official document giving the person’s permanent National Insurance
number and their name issued by a Government agency or a previous employer.
List B Group 1
1. A current passport endorsed to show that the holder is allowed to stay in the UK and is currently allowed to do the type of work in question.
2. A current Biometric Immigration Document (Biometric Residence Permit) issued by the Home Office
3. A current Residence Card (including an Accession Residence Card or a Derivative Residence Card) issued by the Home Office to the holder which indicates
that the named person can currently stay in the UK and is allowed to do the work in question.
4. A current Immigration Status Document containing a photograph issued by the Home Office to the holder with a valid endorsement indicating that the
named person may stay in the UK, and is allowed to do the type of work in question, together with an official document giving the person’s permanent
National Insurance number and their name issued by a Government agency or a previous employer.
List B Group 2
1. A Certificate of Application issued by the Home Office under regulation 17(3) or 18A (2) of the Immigration (European Economic Area) Regulations 2006, to a
family member of a national of a European Economic Area country or Switzerland stating that the holder is permitted to undertake work which is less than 6
months old together with a Positive Verification Notice from the Home Office Employer Checking Service.
2. An Application Registration Card issued by the Home Office stating that the holder is permitted to take the work in question, together with a Positive
Verification Notice from the Home Office Employer Checking Service.
3. A Positive Verification Notice issued by the Home Office Employer Checking Service to the University, which indicates that the named person may stay in the
UK and is permitted to do the work in question.
1. List A You have a continuous statutory excuse for the full duration of the person’s work with you. You are not required to carry out any repeat right to work
checks on this person.
2. List B: Group 1 You have a time-limited statutory excuse which expires when the person’s permission to be in the UK and undertake the work in question
expires. You should carry out a follow-up check when the document evidencing their permission to work expires.
3. List B: Group 2 You have a time-limited statutory excuse which expires 6 months from the date specified in your Positive Verification Notice. This means that
you should carry out a follow-up check when this notice expires.
Documents that do not provide proof of permission to work in the UK

a Home Office Standard Acknowledgement Letter or Immigration Service Letter (IS96W) which states that an asylum seeker can work in the UK. If you are
presented with these documents then you should advise the applicant to call the Border and Immigration Agency on 0151 237 6375 for information about
how they can apply for an Application Registration Card;

a temporary National Insurance Number beginning with TN, or any number which ends with the letters from E to Z inclusive;

a permanent National Insurance number when presented in isolation;

a driving licence issued by the Driver and Vehicle Licensing Agency;

a bill issued by a financial institution or a utility company;

a passport describing the holder as a British Dependent Territories Citizen which states that the holder has a connection with Gibraltar;

a short (abbreviated) birth certificate issued in the UK which does not have details of at least one of the holder’s parents;

a licence provided by the Security Industry Authority;

a document check by the Criminal Records Bureau;

a card or certificate issued by the Inland Revenue under the Construction Industry Scheme.
May 2016
Private and Confidential
VAM Payroll
VAM PERSONAL RECORD FORM
FOR COMPLETION BY WORKER
Please note it will not be possible to process payments without this form. Please complete ALL sections in BLOCK CAPITALS. On
completion of this form you will be have a record on the variable payroll and therefore be subject to tax and National Insurance
at source.
Payroll Number
(Will be set up by
Payroll)
Department
Title
Surname (as official documents)
Forename (s) (as
official documents)
Preferred Forename
Home Address
Please note your address
May be passed onto your
Department for their records
Post Code
Telephone No
Mobile No
Date of Birth
National
Insurance No
D
D
M
M
Y
Y
A
A
N
N
N
N
N
N
A
Gender
Start Date of paid
Work with the
University
der
D
D
M
M
Y
M
If UOW Student
advise Student No
F
Please
(please tick as appropriate)
Y
Payment Details – All payments are made by BACS
For overseas accounts please use the Foreign Bank details form available on the Payroll website. Submit this form with your personal record
form http://www2.warwick.ac.uk/services/humanresources/payroll/expenses/
Sort Code
-
-
Name of Bank
_________________________________________________________________
Account Number
Bank Branch
_______________________________________________
Account Name
Bank Address
_________________________________________________________________
Building Society
Roll Number
Emergency Contact Details (Please provide details to be used in case of emergency)
Contact Name
Telephone No
Mobile No
Please note this information may be passed to your department but will only be used in the event of an emergency
I confirm that the personal information given on this form is correct. I also agree that in the event of overpayment of any salary or other
remuneration, the University is entitled to make the relevant deduction from any subsequent payment(s). The University will let you know
and agree in advance the relevant deduction, but its failure to do so will not affect its right to reclaim the overpayment.
Signed___________________________________
Date_____________________________________
(Please note a typed signature is not valid)
PAYROLL USE ONLY
UK workevidence
Received. List…
A/B
Returned to Dept
_____/_______/_____
For ‘B’ enter the
expiry date of visa
Previous Payroll
Number
PSE
updated by
PSE
checked by
Additional Payroll
Number Unitemp
May 2016
Private and Confidential
VAM Payroll
TAXATION STATUS / STUDENT LOAN/ PENSION INFORMATION/ MARITAL STATUS
FOR COMPLETION BY WORKER
Surname (as official documents)
Forename (s) (as official documents)
Taxation Status – Do not leave this section blank.
Please confirm your current circumstances
Please read all of the statements carefully. You must enter X in the ONE box that applies to you.
A
This is my first job in the current tax year (6 April onwards). I have no other forms of income and I do not receive a pension or state
B
I have received taxable Job Seekers Allowance, Incapacity Benefit, Employment and Support Allowance or this is not my first job in the current tax
year (6 April onwards). However, this is now my only job or main (highest earning) job. I do not receive a state or occupational pension.
C
This is a secondary position (i.e. I work for another organisation excluding Unitemps) or I am in receipt of a state pension.
D
benefits
I have been working for Unitemps in the current tax year (6 April onwards). If you have ticked this box you MUST tick ONE additional statement
below.
I no longer wish to work for Unitemps. (NB Your Unitemps role will be closed and your P45 will be transferred to your new University
post.) (Payroll – advise Unitemps agency worker made to leave.)
I am still engaged with Unitemps and I wish Unitemps to be my main source of income.
I am still engaged with Unitemps and I wish the University to be my main source of income. NB you will need to contact HMRC to change
your tax code tel. 0300 200 3300. UOW tax reference – 190/U50, Unitemps tax reference 120/ZA76059. Until confirmation is received you
will be taxed at basic rate, currently 20%, with no allowance.
If no statements apply then tax will be deducted on code 0T month 1
Student Loan – Please confirm your current circumstances
Please read the following statements carefully and enter an X in each box which applies to you
Statement 1
I have a Student Loan which is not fully repaid. (If you answer yes to statement 1 please go to statement 2)
Statement 2
I am repaying my Student Loan direct to the Student Loan Company by agreed monthly payments and the University shouldn’t deduct loan
repayments from my pay. (If you answer yes to statement 2 then you do not need to answer statements 3 or 4)
Statement 3
I have a Plan 1 student loan
You have a plan 1 student loan if you lived in Scotland or Northern Ireland when you started your course or you lived in England and Wales
and started your course before 1st September 2012
Statement 4
I have a plan 2 student loan
You will have a plan 2 student loan if you lived in England or Wales and started your course after 1st September 2012
Statement 5
I finished my studies before the last 6th April
PENSION
With effect from 1 March 2013 the University of Warwick is required to comply with government legislation to automatically enrol eligible workers into an
occupational pension scheme. This process is called auto enrolment. An assessment will be made to determine your status within the legislative rules at the
time of your first payment and on an on-going basis thereafter. We will write to you at that time to confirm your position. If you are automatically enrolled into
a pension scheme you will have the right to subsequently opt out. The details of the opt-out process including getting a refund, will be explained in your letter.
MARITAL STATUS
Should you be auto enrolled and wish to remain in the scheme, please indicate your marital status by ticking one of the following boxes:Married / Civil Partnership
Widow/Widower
Single
Prefer Not to Say
Divorced
Separated
I confirm that the personal information given on this form is correct. I also agree that in the event of overpayment of any salary or other
remuneration, the University is entitled to make the relevant deduction from any subsequent payment(s). The University will let you know
and agree in advance the relevant deduction, but its failure to do so will not affect its right to reclaim the overpayment.
Signed_________________________________________ (Please note a typed signature is not valid) Date________________________________
May 2016
Private and Confidential
VAM Payroll
EQUALITY AND DIVERSITY FOR COMLETION BY WORKER
Surname (as official documents)
Forename (s) (as official documents)
The University is required to collate and report on equality and diversity information.
Ethnicity
In order for us to comply with this requirement could you choose the entry that best describes your ethnicity?
White
10
Asian/Asian British-Pakistan
32
Mixed-White and Asian
43
Gypsy or Traveller
15
Asian/Asian British-Bangladesh
33
Other Mixed Background
49
Black/Black BritishCaribbean
Black/Black British-Africa
21
Chinese
34
Arab
50
22
Other Asian Background
39
Other Ethnic Background
80
Other Black Background
29
Mixed-White and Black Caribbean
41
Prefer Not to Say
98
Asian/Asian British-India
31
Mixed-White and Black African
42
Please enter your nationality
Religion
What is your religion?
No religion
Jewish
Any other religion or belief
Buddhist
Muslim
Prefer not to say
Christian
Sikh
Hindu
Spiritual
Gay man
Prefer not to say
Gay woman/lesbian
Heterosexual/straight
Sexual Orientation
What is your sexual orientation?
Bisexual
Other
Disability
The Equality Act 2010 states that a disabled person is someone who has a physical or mental impairment which has a substantial, adverse and long-term (usually
12 months or greater) effect on their ability to carry out their day to day duties. If your impairment would have a substantial effect on you without medication
then this part of the definition would be satisfied (this excludes glasses or contact lenses). Please note that cancer, HIV, multiple sclerosis, are automatically
classed as a disability from the day of diagnosis.
Do you have a disability?
Y
N
The University is required by the Higher Education Statistics Agency (HESA), to collect information from staff on the nature of their disability. The following list
has been drawn up by HESA and provided to all universities to ensure consistency of data collection.
If you indicated Yes to the disability question above, please select at least one disability from the options below.
Blind or serious visual impairment
Mental health condition (eg depression or schizophrenia)
Cognitive impairment (eg autistic spectrum disorder or resulting from a head
injury)
Physical impairment or mobility (eg use of arms or using a wheelchair or
crutches)
General learning disability (such as Downs syndrome)
Other type of disability
Long-standing illness (eg diabetes, epilepsy, cancer, HIV, or chronic heart
disease)
Prefer not to say
Deaf or serious hearing impairment
Specific learning disability (such as dyslexia or dyspraxia)
This information is confidential, however, in order to ensure that appropriate reasonable adjustments and support are
in place to assist you in your role, do you agree to meet with your line manager and HR Advisor for your department, to
discuss support mechanisms
Yes
No
If responding Yes a meeting will be organised by the HR Adviser for your department.
May 2016
Private and Confidential
VAM Payroll
HESA INFORMATION FOR COMLETION BY WORKER
Surname (as official documents)
Forename (s) (as official documents)
As part of its statistical reporting the University must make annual returns to HESA (Higher Education Statistics Authority). To assist in the reporting of this data
PLEASE tick the appropriate statements below:
Previous work/employment before Warwick
Another Higher Education Institute in the UK. Please provide the name of the institution:
01
HEI in an overseas country
02
Student in UK
07
Private industry/commerce
in UK
12
Other education
institution in UK
03
Student in an overseas country
08
Self-employed in UK
13
Other education
institution in an overseas
country
Research institution in UK
04
NHS/General medical or dental
practice in the UK
09
Other work/employment in
UK
14
05
Health services in an overseas
country
10
Other work/employment in
an overseas country
15
Research institution
overseas
06
Other public sector UK
11
Not in regular
work/employment
21
Please enter your nationality
PLEASE Tick the entry that relates to your highest qualification
Doctorate
Other Higher Degree
PGCE
Other Postgraduate Qualifications (in professional)
First Degree
First Degree with Qualified Teacher Status (QTS)
Other qualifications at first degree level including professional
Diploma of HE
HND/HNC
Other undergraduate qualification (including professional)
A level, Scottish Higher or equivalent (NVQ/SVQ 3)
O level /GCSE or equivalent (NVQ/SVQ 2)
Other qualifications
No qualifications
01
02
03
09
11
12
19
21
22
29
31
32
97
98
Academic teaching qualification - Please state if you have any
teaching qualifications or have been recognised in other ways for
your teaching experience regardless of your current position.
_____________________________________________
Current academic teaching discipline 1 – If you will be doing
teaching or research work, please indicate the academic discipline
that covers your primary subject area.
______________________________________________
Current academic discipline 2 – If you will be working in more than
one subject area, please indicate the academic discipline that
covers your secondary subject area.
________________________________________________
May 2016
Private and Confidential
VAM Payroll
Our refTier4Visa/Croatia
Dear Student
If you are an international student studying in the UK and hold a Tier 4 student visa or are a Croatian national in
receipt of a Yellow Registration Certificate and you intend to undertake any paid work you must adhere to the
Immigration rules relating to student working. You cannot be self-employed, provide services as a professional
sportsperson or entertainer or fill a full time permanent vacancy in the UK. If you are a national of Croatia you can
live and study in the UK without restriction, but must obtain an EU Yellow Registration Certificate before taking up
any work. The maximum number of hours you can work each week depends on the type of course upon which you
are registered.
Undergraduate course
You can work for a maximum of 20 hours per week during term time with no restriction on hours during the
University vacations. The 20 working hours per week applies to all work (with any organisation) you are
paid for. During vacation you have no restriction on the hours worked but should you work more than 20
hours per week during term time you will only be paid for a maximum of 20 hours.
Postgraduate course - Master’s
You can only work for a maximum of 20 hours per week for the duration of your course.
Postgraduate course - PhD
You can work for a maximum of 20 hours per week for the duration of your course.
Completion of Studies (Undergraduate and Postgraduate)
If you have confirmation you have passed your degree (either by presenting the degree certificate or official
confirmation from the University) you can work full time for the remaining period of time left on your visa providing
this period is 6 months or less. Croatian students – You will not have an end date on your Yellow Registration
Certificate, but you must inform HR when you have completed your studies because you will no longer be eligible to
work under student rules when you are no longer registered as a student at a UK HEI.
Before undertaking any work submit this form together with a copy of your student visa/yellow registration
certificate to the Departmental Administrator/Secretary of the department who wish to employ you. If you have
completed your studies and wish to work full time refer to the paragraph above. After the work has been
completed, the department for whom you worked will request Payroll to pay you.
By signing the attached declaration you are agreeing to comply with these rules at all times. You must advise Human
Resources of any change in circumstances in your work or student status. The University is legally obligated to
comply with the Immigration rules and action will be taken against any student found to be in breach of the rules.
Yours sincerely
HR Manager
HR Services Manager
The University of Warwick
Coventry CV4 8UW United Kingdom
Tel: 024 7652 22720
Fax: 024 7652 4583
Email:
May 2016
Private and Confidential
VAM Payroll
STUDENT DECLARATION FORM
FOR COMPLETION BY WORKERS WHO HOLD A TIER 4 STUDENT VISA
For Tier 4 visa holders and Croatian students with a Yellow Registration Certificate
Surname (as official documents)
Forename (s) (as official documents)
Student Number: (Mandatory for University of Warwick Students)
Full name of institution of study (Mandatory): __________________________________________________________________________________
Level of Course: (tick one box below):
Undergraduate
Masters
PhD
Expected date of completion of studies:
D
D
M
M
Y
Y
Proof of the term dates of the University at which you are enrolled as a student must be provided, this can be a print
out from the University’s website. This is required for undergraduate students wishing to undertake paid work. NB:
postgraduate students are not allowed to work for more than 20 hours per week for the duration of their studies.
NB: By signing the statement below you are confirming your compliance with UKVI Regulations; if you do not sign
and return this form to Human Resources you will not be paid for any work undertaken.
--------------------------------------------------------------------------------------------------------------------------------------Student Declaration
I agree to undertake any paid work in accordance with the UKVI regulations which apply to working under the
restrictions of my tier 4 student visa. Details of the working restrictions relating to student visas can be found on the
Human Resources website: http://www2.warwick.ac.uk/services/humanresources/newpolicies/student_workers
Signed………………………………………………………………………… Date …………………………………………………………………….....
(Please note a typed signature is not valid)
Print name………………………………………………………………….
Department (at University of Warwick) requesting work assignment: _______________________________________
Name of department contact:
______________________________________________________________
Work to be undertaken:
______________________________________________________________
Number of hours worked per week:
___________________
Dates of work from:
___________________ to _____________________
Proof of the university term dates as relating to your course must be attached.
Please return to the Departmental Administrator/Secretary of your employing department to return to
Human Resources before you commence work with a copy of relevant documentation.
May 2016