Housing Benefit and Council Tax Support Certificate of Earnings

This form will ask you to provide

your details including National Insurance number
your Housing Benefit or Council Tax Support reference number (if known)
employer's full name or company name
employer's address and phone number

Your employer will need to complete this form or provide a proof letter stating:

your employment start date
hours you normally work per week
your normal basic hourly rate
date of their last pay increase
how often you are paid (weekly, fortnightly etc) and how you are paid (cash, cheque, bacs etc)
for the current financial year (please state from and to dates this period covers) to date the gross pay, tax and net National Insurance
your earnings for the last five weeks if paid weekly, three fortnightly payments, or two monthly/four weekly payments. Figures must include bonuses, overtime and commission. Actual earnings (including any SSP or SMP paid)
- date paid
- gross pay
- income tax deductions
- employee's National Insurance contributions
- employee's contribution to pension scheme
- SSP or SMP
- hours worked
- take home pay (net)
- if the earnings for this period are typical, if not are they higher or lower
if you have been employed for less than 5 weeks, we will need your estimated earnings
- gross pay
- income tax deductions
- employee's National Insurance contributions
- employee's contribution to pension scheme
- hours worked
- take home pay (net)

This information can be provided by

the employer completing this form
uploading the employer proof letter to this form

You can upload the letter to this form now or you can send it later but we won't process your application until we have received your proof. You must send your proof within the next two weeks otherwise we will cancel your application and you will need to reapply, if you wish to do so.

Please have this information ready as pages time-out after one hour.

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Privacy Statement

To provide this service Thanet District Council will collect and process personal information. We may check some of the information with other sources (e.g. government departments and other councils) to verify your identity and ensure that the information you have provided is accurate.

Your personal information is being processed because it is necessary for compliance with a legal obligation or for the performance of a task carried out in the public interest.

Please refer to our Corporate Privacy Notice for further details on how we process your personal information and your rights. This is also available in other formats (e.g. print).

The person completing this form declaration

I am(Required)

the claimant

the employer

Please check the box below to confirm that you have read, understand and agree to the following statements before completing this form:

As far as possible, I will confirm with the person claiming that the answers I will give on this form are correct
I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me.
I understand my data may be shared with other departments as permitted by law.

Please check the box below to confirm that you have read, understand and agree to the following statements before completing this form:

I confirm the details I will give are correct and that any documents I will upload as proof are original copies and have not been edited in any way.
I confirm that I will notify you of any relevant changes straight away.
I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me.
I understand my data may be shared with other departments as permitted by law.

About you

Your full name(Required)

Your position held in the company(Required)

Your contact phone number(Required)

Your email address(Required)

Enter Email Confirm Email

About you the employer

Employer’s full name or company name(Required)

Employer’s phone number(Required)

Employer’s address including postcode(Required)

About the employee (the claimant)

Employee's first name(Required)

Employee's last name(Required)

Employees phone number, if known

Employee's address including postcode(Required)

Employee's National Insurance number(Required)

About the claimant's employment

What date did their employment start?

What is their normal basic hourly rate?(Required)

How many hours do they normally work per week?(Required)

If applicable, what was the date of their last pay increase?

How often is your employee paid?(Required)

How is your employee paid?(Required)

Details of how your employee is paid(Required)

For the current financial year, please state your employee’s:

Gross pay - amount paid to date(Required)

Tax - amount paid to date(Required)

Net National Insurance - amount paid to date(Required)

Pension contributions - amount paid to date(Required)

For the above figures, what period does this cover

Date period covers from(Required)

Date period covers to(Required)

About the claimant's earnings

Has the claimant been employed for less than five weeks?(Required)

Yes

No

More than five weeks

Employee’s earnings for the last five weeks if paid weekly, three fortnightly payments, or two monthly/four weekly payments. Figures must include bonuses, overtime and commission. Actual earnings (including any SSP or SMP paid)(Required)

Date paid (dd/mm/yyyy)(Required)

Week 1

Week 2

Week 3

Week 4

Week 5

Gross pay - amount paid £0.00(Required)

Week 1

Week 2

Week 3

Week 4

Week 5

Income Tax deductions - amount paid £0.00(Required)

Week 1

Week 2

Week 3

Week 4

Week 5

Employee’s National Insurance contributions - amount paid £0.00(Required)

Week 1

Week 2

Week 3

Week 4

Week 5

Employee’s contributions to pension scheme - amount paid £0.00(Required)

Week 1

Week 2

Week 3

Week 4

Week 5

SSP or SMP - amount paid £0.00(Required)

Week 1

Week 2

Week 3

Week 4

Week 5

Hours worked - number of hours worked(Required)

Week 1

Week 2

Week 3

Week 4

Week 5

Take home pay (net) - amount paid £0.00(Required)

Week 1

Week 2

Week 3

Week 4

Week 5

Less than five weeks

If they have been employed for less than 5 weeks(Required)

Gross pay - estimated earnings(Required)

Income Tax deductions - estimated earnings(Required)

Employee’s National Insurance contributions - estimated earnings(Required)

Employee’s contributions to pension scheme - estimated earnings(Required)

Hours worked - number of hours(Required)

Take home pay (net) - estimated earnings(Required)

Are the earnings for the above period typical?(Required)

Yes

No

Are they usually higher or lower?(Required)

Higher

Lower

About you the claimant

Title (for example Mr, Mrs, Ms, Miss)(Required)

First name(Required)

Last name(Required)

Contact phone number(Required)

Email address(Required)

Enter Email Confirm Email

Claimant's address(Required)

National Insurance number(Required)

Housing Benefit or Council Tax Support reference number (if known)

About your employer

Employer’s full name or company name(Required)

Employer’s phone number(Required)

Employer’s address including postcode(Required)

Address lookup

Postcode(Required)

Search Postcode

Hidden

address(Required)

About your address

House name or number(Required)

Street name(Required)

Town(Required)

Postcode(Required)

Hidden

Staff ID

Upload proof

You need to provide a proof letter from your employer stating:

your employment start date
hours you normally work per week
your normal basic hourly rate
date of their last pay increase
how often you are paid (weekly, fortnightly etc) and how you are paid (cash, cheque, bacs etc)
for the current financial year (please state from and to dates this period covers) to date the gross pay, tax and net National Insurance
your earnings for the last five weeks if paid weekly, three fortnightly payments, or two monthly/four weekly payments. Figures must include bonuses, overtime and commission. Actual earnings (including any SSP or SMP paid)
- date paid
- gross pay
- income tax deductions
- employee's National Insurance contributions
- employee's contribution to pension scheme
- SSP or SMP
- hours worked
- take home pay (net)
- if the earnings for this period are typical, if not are they higher or lower
if you have been employed for less than 5 weeks, we will need your estimated earnings
- gross pay
- income tax deductions
- employee's National Insurance contributions
- employee's contribution to pension scheme
- hours worked
- take home pay (net)

This information can be provided by

the employer completing this form
uploading the employer proof letter to this form

You can upload the letter to this form now or you can send it later but we won't process your application until we have received your proof. You must send your proof within the next two weeks otherwise we will cancel your application and you will need to reapply, if you wish to do so.

Will you upload the proof letter from your employer to this form now?(Required)

I will upload the proof to this form now

I can't upload the proof to this form now, I'll send it within the next two weeks

Upload proof(Required)

Drop files here or

Max. file size: 32 MB, Max. files: 3.