Cis Registration Personal Details Title Forenames Surname Address Line 1 Address Line 2 Address Line 3 Town Postal Code Date of Birth Day12345678910111213141516171819202122232425262728293031 MonthJanFebMarAprMayJunJulAugSepOctNovDec Year 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Mobile Telephone Home Telephone Email Address Confirm Email Address NI Number Gender Please SelectMaleFemaleOther Nationality UTR Number Self-Employment Type Please SelectSoletraderCompany If your UTR number is that of a Company please provide the following: Full Company Name Company Reg Number Are you VAT registered YesNo Contract Details Job Title Rate Employment Agency (if applicable) Contact Name Contact Telephone Number Contact Email Address End Client Site / Address Assignment Start Date Identification Details You will need to submit a primary copy of ID to Exact Payroll. You can submit this to us online, or post/email this to us if you prefer (please indicate by ticking the appropriate box in each instance). Primary Identification consists of either a copy of your Passport, or a copy of your Birth Certificate together with confirmation of your National Insurance number. Proof of ID * (Allowed File-format : pdf, txt, doc, docx, jpg, jpeg, png, gif, xls, xlsx, csv) I shall return this via post Eligibility to work in the UK Please SelectI am a UK CitizenI am a citizen of an EU countryI am a citizen of a non EU Country Please provide your 'EU Share Code' Additional information in relation to 'EU Share Codes' can be found Here. Upload ETW document Will return by post Bank Details Are you the account holder Please SelectYes Name of Bank Bank Sort Code Name as it appears on the bank account Bank Account Number Email Address of the bank account holder. You have indicated that the above bank details are in the name of a third party (e.g. the bank details are not in your name).We are required by law to ascertain that the appropriate consent to hold or process data is done so with the individual's explicit consent. Please tick here to confirm that you have received explicit consent from the individual that their details will be held by Exact Payroll and that data processing inline with our privacy policy will be conducted. Source of Referral How did you hear about Exact Payroll? Please SelectRecommendation by ContractorRecommendation by AgencyWebsiteSearch EngineWord of MouthMagazineNewspaperUsed in pastOther Name of Contractor Name of Agency Confirmation By providing my details to you I confirm and acknowledge: That it is my intention to use Exact Payroll as my Umbrella company for more than one assignment; I believe that the assignments will be temporary in nature, each lasting less than 24 months, and I will inform Exact Payroll immediately should my expectation become that an assignment will be extended past the 24 month point. That it is a requirement to supply Exact Payroll with a valid copy of my ID, and where appropriate, Eligibility to Work documents, and that failure to do so will result in non-payment. That I understand my prospective payment method including any tax and NI deductions where applicable. That I understand that I will be required to sign an Exact Payroll Contract and that failure to do so will result in non-payment. That all information provided is true and accurate and is being provided with my full consent. I accept You agree to Exact Payroll holding your personal data. If you do not wish for us to hold or process your data, then we are unable to process the information within this form Privacy Policy Are you working in the construction industry and genuinely self employed? YesNo Signed (please enter your name)
