Pre NESA Questionnaire

For individuals who may be engaged to supply services to the University

PART 1 – To be completed by the individual, company or partnership engaged to do work:

"During 2017, Her Majesty’s Revenue & Customs introduced changes to the IR35 Intermediaries Legislation which requires public bodies to identify individuals operating as Personal Service Companies through an ‘intermediary’ (often their own Ltd company or Partnership) and assess engagements provided by PSC’s, in line with HMRC requirements".

To enable the university to assess how we may engage you to supply these services, please complete this questionnaire by answering the questions below and sign at the bottom. All questions marked with an asterisk * must be answered.

Full Name
(of individual providing the services) *
National Insurance Number *
(if not applicable, please specify 'n/a')
Company / partnership/trading name/sole trader name*
(if not applicable, please specify 'n/a') *
Address *
Post Code *
Telephone No *
  1. Are you supplying your services as: * (please mark as appropriate below)

An individual / Y/N
A sole trader / Y/N

If you have answered ‘ Y’ to either question in 1 above, go to question 3.

  1. Are you supplying your services as or through: (please mark as appropriate)

A company registered in the UK with Companies House * / Y/N
A company registered overseas * / Y/N
A type of partnership,
If so, please indicate the nature of the partnership * / Y/N
Private / Limited / Limited Liability
As the worker, do you have a material interest of 5%
ormore in the company/partnership? * / Y/N - See HMRC guidance for further information

Please specify number of employees in company/partnership *
  1. Please provide all relevant business registration numbers:

Company Registration number
Unique Taxpayer Reference
(where no Company Registration number)
Overseas business registration number
VAT registration number
(if not applicable, please specify 'n/a')
  1. Please indicate how you will operate this engagement: *

Will you submit an invoice for the services provided? / Y/N
Substitution' - in the event you are unable to perform part/all of the contracted services, could you provide a substitute with the same skills/experience?
(The substitute does not need to be an employee but a person to whom you are able to sub-contract the work and to whom you will be responsible for paying) / Y/N
  1. Are you currently employed as an employee or a worker (through a casual / hourly-paid contract) by and receive a payslip from the University? Y/N *
  • I am a current employee at the University of BathY/N
  • I am a current worker at the University of BathY/N

Please sign below to confirm that the information in this questionnaire is accurate:

Signed:

Dated:

Please return completed form to:Engager to specify return email address

Thank you

PART 2 - INTERNAL USE ONLY

To be completed by the University of Bath (engager)

Engagement details:

Description of services to be provided
Start Date
End Date
Estimated Total Value of Engagement

Please can you answer question 1 to 5 below ticking either box (A) or box (B) for each question. Please then sign the form below.

Employment Status questions (A) / Tick
if
Yes / Employment Status questions (B) / Tick if Yes
1. The work has already started / Or the work has not yet started
2. The work to be undertaken could be carried by a wide range of individuals who have the basic skills and training. / Or the work to be undertaken is highly specialised and could only be carried by an individual or individuals with a high level of specialist knowledge, training (and / or qualifications) and experience.
3. The worker would never send someone else to do the work (a substitute) / Or the worker could send a substitute from their company or another company (i.e. a sub-contractor) for some of the work if they were unable to fulfil this?
4. If the worker's business sent a substitute and they met all the necessary criteria, we would reject them? / Or if the worker's business sent someone else to do the work (a substitute) and they met all the necessary criteria, we would accept them?
5. If a substitute was provided the University would only pay the substitute directly / Or if a substitute was provided the University would pay the contractor who would be required to pay the substitute?

Please sign below to confirm that the information in part 2 of this questionnaire is accurate:

Signed:Dated:

Post:Dept:

Pre NESA Questionnaire 02-18 v2.docx