Employee Set up form HR 101
This form is to used to hire or rehire employees on SAP HR. Failure to fully complete the form will result in delays to salary payments.
HR 101_V15 Sep 2018 Page 1 of 5 Revised 14/09/2018
Please complete in block capitals & place a tick
in the appropriate boxes
Hire Re-hire Permanent Temporary
Personnel Number Start Date
Section 1 - 7 should be completed by Employee/Payee
1. Personal Information
Title Mr Mrs Ms Miss Dr Sr. Rev. Fr. Prof.
Surname First Name
Known as Initials
Street Address
Town/City County
Eircode Country
Phone No Mobile Phone No
Email address for online payslip purposes
Former Name Nationality
Gender Male Female
Date
of Birth
Civil Status Single Married Civil Partnership Widowed Divorced Separated Co-Habiting
PPS
Number
2. Next of Kin (Emergency Contact Details)
Surname First Name Relationship to you
Street Address
Town/City County
Eircode Country Mobile Phone No
3. Employment History
Note: Please ensure P45 / Certificate of Tax Cut Off / PRD45 are forwarded to the appropriate payroll department
Are you currently directly
employed by HSE/Public
Service
Yes
No
If currently employed by HSE please provide details of your personnel number below
Were you previously employed by HSE / Health Board / Voluntary Hospital / National Hospital/ Public Service Employer?
Yes No If No please go to section 4
If previously employed by HSE / Health Board / Voluntary Hospital / National Hospital/ Public Service Employer please provide the following details. (Note:
if you have had multiple assignments with these employers please provide details of your latest employment)
Name of
Employer
Last Day of service
Grade
Personnel Number
Are you in receipt of a pension under the Local Government Superannuation Scheme or HSE Superannuation Scheme? Yes No
If
Yes
please provide information requested below
Name of
Authority/
Employer
Start Date of Payment
HR 101_V15 Sep 2018 Page 2 of 5 Revised 14/09/2018
4. Qualification Details
Irish Language Proficiency
Oral Irish Validated - Yes
No
Written Irish Validated - Yes
No
5. Professional Registration
Note
: only applies to Medical & Dental, Health & Social Care Professionals & Nursing. If this section does not apply to you go to Section 6. If you
have multiple registrations please complete Appendix 1
below
.
Name on
Registration
Registration
Body
Date of Issue Expiry Date
Professional Registration/Membership Number
Application Status
(Medical Council)
Trainee Specialist
Division
Internship Division Specialist Division General
Division
Supervised
Division
Visiting EEA
Practitioners
Division
Official use only
Name of Qualification Date from
Proficiency/
Grade awarded
Qualification Code
(if applicable)
Validated
Please (
) tick one
Yes No
Yes No
Yes No
Yes No
6. Bank Details
Bank
Name
Bank Address
Sort Code Account No
Payee Name
Bank Identifier Code (BIC)
SEPA Bank Account No (IBAN)
7. Employee Declaration
I declare that the above information is accurate and correct on the date below. I undertake to notify my employer of any changes to this information by
completing and submitting the appropriate form.
Signature Date
Appendix 1 Multiple Registrations
Name on
Registration
Registration
Body
Date of
Issue
Expiry Date
Professional Registration/Membership
Number
Name on
Registration
Registration
Body
Date of Issue Expiry Date
Professional Registration/Membership
Number
HR 101_V15 Sep 2018 Page 3 of 5 Revised 14/09/2018
Section 8 - 15 should be completed by HBS Recruitment/Hiring Manager/Line Manager
8. Appointment Details – Please select reason for Appointment
Fill Existing Vacancy Sick Leave Relief Redeployment
Fill New Vacancy Urgent Service Needs(Special) SJH Hire Pension Purposes Only
Special Project Locum On-Call Relief Agency Subsumed into HSE
Student Training Post Locum Relief Temp Appointment from other HSE area
N.B. Use HR3 Form
Agency Staff Converted to EE Maternity Leave Relief Retiree
Replaced Employee Personnel No.
Grade Org Unit No.
Position Number Position Name
Personnel Area Cost Centre
Employee Group
Permanent
Temporary
Officer
Non Officer
External
Employee
Sub
Group
Wholetime
Part-time
Casual
Fees/ Sessions
9. Contract Type – [please attach signed contract]
Indefinite Duration
Indefinite Duration
Std T&C’s 06/2014 Fixed Term
Fixed Term Std T&C’s
06/2014
Specified
Purpose
Specified Purpose
Std T&C’s 06/2014
Indefinite Duration
Std T&C’s
Fixed Term
Std T&C’s
Specified Purpose
Std T&C’s
Consultant Contract type
A B B* C Other
Expiry date of
Temporary Contract
Probation period to be served Yes No
1st probationary
Review date
2
nd
probationary
r
eview date
10. Service year date (for annual leave purposes)
Note:
Certain grades are entitled to incremental increases to the annual leave entitlement based on length of service in the grade. Please complete the
following section so that the correct entitlement may be established.
Is the employee entitled to incremental increases to annual leave, based on length of service? Yes No
Nursing Grades Only
If yes please enter the number of years, months and days of previous service. Note: Please include all previous
service in publicly funded health services in Ireland and relevant nursing experience abroad
Years Months Days
Other Grades
If yes please enter the number of years, months and days of relevant service at this grade. Note: Please include
service if the employee was acting up continuously in the same grade immediately prior to start date
Years Months Days
11. Work Pattern
Wholetime Standard hours for this grade Contract Hours for EE (use decimals)
Working Week Mon – Fri 5/5 Mon – Sun 5 / 7 Work Rule Schedule (if casual enter HRPD)
Note:
Employee works a Monday to Friday roster they are classified as 5/5 & will not receive Sat allowance or Sunday/BH premium.
Alternatively if an employee works on Saturday or Sunday they are classified as 5/7 & will be paid the relevant allowances & premium.
.
HR 101_V15 Sep 2018 Page 4 of 5 Revised 14/09/2018
12. Pay Details
Work Location
Allowance
Please ensure that supporting
documentation is attached
Amount/Unit
Wage Type/Pay Code
Official Use Only
1
2
13. Pension Details
Superannuation classification to be completed in all cases Non New Entrant New HSE Entrant SPSPS
PRSI Class (as per P60) :
Please indicate the relevant
superannuation scheme
Officer
Non Officer
PRSI Class A PRSI Class D
1956 Scheme
120
120
200
1977[Revision Scheme] –
Main Scheme
160
140
220
Spouses’ & Children’s
320
320
420
Widows’ & Orphan’s N/A 300
400
HSE Employee Superannuation Scheme – Main Scheme
(Officer & Non Officers)
165
Spouses’ & Children’s
325
Public Service Pensions [Single Scheme]
170
14(a) HBS Recruit Signature
Date
14 (b) Hiring Manager/Delegated Officer Declaration
I declare that the above information is accurate and correct. I confirm that the above employee commenced employment on the date stated above and
approve set up on the appropriate HR/payroll system.
Signature
Date
Name (Print) Grade
Contact Tel No Decision Number (if applicable)
E-Mail Address
16. Payroll Section
Location Code
Name (Print) Signature
Tel No Date
17. Payroll Interface (phase 1 Only)
Wage Type Entered Employment Signal
Payroll Area Change Details Date
Main Pension Scheme W&O/Spouses Scheme
Annual Salary € Level (Point of Scale) Grade Code
Pay Scale Type
Next Increment due Payroll Area/Group No
Payroll Frequency Weekly Fortnightly 4 weekly Monthly
HR 101_V15 Sep 2018 Page 5 of 5 Revised 14/09/2018
PAC Completed Date
Signed
Email
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