Instructions for employers
This Starter Checklist can be used to gather information about your new employee. You can use this
information to help fill in your first Full Payment Submission (FPS) for this employee. You need to keep
the information recorded on the Starter Checklist record for the current and previous three tax years.
Do not send this form to HM Revenue and Customs (HMRC).
Instructions for employees
As a new employee your employer needs the information on this form before your first payday to tell HMRC
about you and help them use the correct tax code. Fill in this form then give it to your employer.
Do not send this form to HMRC.
Employee’s personal details
Do not enter initials or shortened names such as Jim for
James or Liz for Elizabeth
Are you male or female?
Date of birth DD MM YYYY
National Insurance number (if known)
Employment start date DD MM YYYY
Starter checklist Page 1 HMRC 04/16
Please turn over >
This is my first job since last 6 April and I have not been receiving taxable Jobseeker’s
Allowance, Employment and Support Allowance, taxable Incapacity Benefit,
State or Occupational Pension.
This is now my only job but since last 6 April I have had another job, or received taxable
Jobseeker’s Allowance, Employment and Support Allowance or taxable Incapacity Benefit.
I do not receive a State or Occupational Pension.
As well as my new job, I have another job or receive a State or Occupational Pension.
You need to select only one of the following statements A, B or C