PGS1 (0417)NEWCASTLE UNIVERSITY

POSTGRADUATE DEMONSTRATOR NEW STARTERS FORM

Please read the Postgraduate Demonstrator policy and guidance on the HR website before completing this form.

Please forward this form which the first period of work is carried out. No later than 12th of the month (unless this falls on a weekend then it must be the Friday before). THIS FORM MUST NOT BE ALTERED IN ANY WAY.

SECTION 1 – FOR COMPLETION BY THE POSTGRADUATE STUDENT
(ALL FIELDS ARE MANDATORY UNLESS OTHERWISE STATED)
  • THE FOLLOWING PERSONAL INFORMATION IS REQUIRED BY HM REVENUE & CUSTOMS(Please see Statement of Arrangements)
  • NAMES MUST BE PRECISELY AS SHOWN ON OFFICIAL DOCUMENT e.g. PASSPORT
  • FAILURE TO PROVIDE ACCURATE AND COMPLETE INFORMATION WILL MEAN PAYMENT CANNOT BE PROCESSED
Title: ______Surname (Last Name): ______Middle Name(s):______
First Name: ______Preferred First Name: ______
National Insurance Number: ______Date of Birth:______(DD/MM/YY)
Tick here if you have never had a National Insurance Number see note in the Statement of Arrangements
MALE / FEMALE (Delete as appropriate) Nationality:______
Home Address in UK: ______
______Post Code: ______
Telephone Numbers: Mobile: ______Home: ______
Works Address: ______
(Academic/Service Unit & Building for any internal correspondence)
TAX FORM DECLARATION (This must be completed even if a P45 is enclosed with this form)
Your present circumstances
Read all the following statements carefully and enter 'X' in the one box that applies to you.
A – This is my first job since last 6 April and I have not been receiving taxable Jobseeker's Allowance, Employment and Support Allowance or taxable Incapacity Benefit or a state or occupational pension. A
OR
B – This is now my only job, but since last 6 April I have had another job, or have received taxable
Jobseeker's Allowance, Employment and Support Allowance or taxable Incapacity Benefit. I do not
receive a state or occupational pension.B
OR

C – I have another job or receive a state or occupational pension. C
Student Loans (advanced in the UK)
If you left a course of UK Higher Education before last 6 April and received your first UK Student Loan
instalment on or after 1 September 1998 and you have not fully repaid your Student Loan, enter 'X' in
box D.
(Do not enter ‘X’ in box D if you are repaying your UK Student Loan by agreement with the UK Student
LoansCompany to make monthly payments through your bank or building society account.) D
BANK ACCOUNT DETAILS
Payment will be made by Bacs, into a UK bank or building society of your choice on the LAST working day of each month.Please complete your details as clearly as possible.
Name on the Account: ______(name on yourbank statement/card etc)
Sort Code: (6 digits) __ __ - __ __ - __ __ Account Number: (8 digits)______
Building Society Roll Number: (if applicable)______
Visa Start Date: ______(DD/MM/YY) Visa End Date: ______(DD/MM/YY)
(if applicable) (if applicable)
Student email address: ______Student Number:______
PENSIONS AUTO ENROLMENT:
With effect from May 2013, if your total earnings from the University reach the auto enrolment trigger, currently and you are aged 22 or over and under State Pension Age, you will be auto-enrolled into a qualifying pension scheme. For further information see
DECLARATION – I confirm that the information supplied is correct
POSTGRADUATE’S SIGNATURE ______ DATE ______
SECTION 2 – FOR COMPLETION BY THE POSTGRADUATE STUDENT
This data is used solely for monitoring purposes
What is your ETHNIC GROUP? Please tick the most appropriate box to indicate your background.
A White White
Gypsy or Traveller / B Mixed
White and Black Caribbean
White and Black African
White and Asian
Any other Mixed background / C Asian or Asian British
Indian
Pakistani
Bangladeshi
Any other Asian background
D Black or Black British
Caribbean
African
Any other Black background / E Other ethnic group
Chinese
Arab
Any other Ethnic background / If you have ticked an ‘Other’ box, please write in the details below:
Information refused
Do you have a disability? / Yes / No / Information refused
If you have declared a disability please liaise with the Academic/Service Unit to discuss any arrangements or adjustments that may be necessary.

SECTION 3 - FOR COMPLETION BY THE HEAD OF ACADEMIC/SERVICE UNIT OR OTHER AUTHORISED PERSON
DATE OF APPOINTMENT FROM:______(DD/MM/YY) *
* For payroll purposes the start date will be when the postgraduate demonstrator undertakes the first period of work.
DATE OF APPOINTMENT TO:______(DD/MM/YY)**
** If no PGS2 form is received by payroll within three months of appointment to date, the postgraduate demonstrator will be made a leaver and the P45 posted to the home address held on SAP. Any changes of address should be notified to payroll.
Position Code: ______Cost Centre Code:______
(Please choose the correct position code from the list found at )
Non-EEA Students Only
VISA ELIGIBILITY FROM: ______(DD/MM/YY) TO: ______(DD/MM/YY)
(if applicable)
Note: The appointment date cannot extend past the end date of the current visa.
Non-EEA Students may not work more than 20 hours per week during term-time.
Is this individual likely to be exposed to allergens and require an allergy test?Yes No
______
DECLARATION
I confirm that I have seen documentary evidence confirming identity and eligibility to work for this student, I have verified the details and I have retained a certified copy.
It is the manager’s responsibility to check the validity of the original document and the accuracy of the information in it, to take a copy, sign and date it, and retain this copy in the Unit. THIS APPLIES TO ALL POSTGRADUATE DEMONSTRATORS (EEA & NON-EEA). Audit checks may be carried out by the Immigration authorities. Non-compliance could result in the University’s licence being down-graded;the licence being cancelled; civil penalties being incurred or even criminal prosecution.This could apply to all Tiers that the University holds a licence for.
I confirm that all information in this form is correct.
I confirm that a copy of the “Statement of Arrangements” has been given to the Postgraduate Demonstrator.
SIGNATURE: ______
NAME (Please Print):______DATE:______
ACADEMIC/SERVICE UNIT: ______
  • It is the responsibility of the Academic/Service Unit to ensure all details have been accurately recorded.
  • The fully completed form should be sent to the Payroll Departmentin which the first period of workis carried out.
  • A copy of this form and the verified copies of the passport and eligibility work should be retained in the Academic/Service Unit.

Page 1 of 3Postgraduate Demonstrator New Starters Form (PGS1)May 2017