The Self Certification Form Template UK is offered in multiple formats, including PDF, Word, and Google Docs, featuring both editable and printable versions for your convenience.
Self Certification Form Template UK Editable – PrintableSample
Self Certification Form Template UK 1. Individual Information 2. Employment Information 3. Income Information 4. Declaration of Residency 5. Declaration of Tax Status 6. Consent and Understanding 7. Signature and Date 8. Additional Notes 9. Declaration of Accuracy
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[Full Name]
[Date of Birth]
[National Insurance Number]
[Address]
[Phone Number]
[Email Address]
I declare that I reside at the above address and that the information provided in this form is accurate and complete to the best of my knowledge. I understand that providing false information may result in legal repercussions.
Please provide details of your income sources:
– Employment Income: [Amount]
– Self-Employment Income: [Amount]
– Other Income (e.g., rental, dividends): [Amount]
I confirm that my total taxable income in the current financial year is below the personal allowance threshold set by HM Revenue & Customs. I understand that I may be required to submit further documentation or evidence if requested.
Please attach copies of the following documents:
– Recent pay slips or income statements
– Proof of address (e.g., utility bill)
– Any other relevant documentation.
[Signature of the Applicant]
[Date]
[Full Name]
[National Insurance Number]
[Current Address]
[Contact Number]
[Email Address]
I hereby certify that the information provided in this form is true, accurate and complete. I acknowledge the consequences of providing misleading information.
Please detail your income sources below:
– Salary (Employer Name): [Amount]
– Freelance Work: [Amount]
– Other Income: [Specify and Amount]
I declare that my income falls within the personal allowance threshold, and I am not liable for any Income Tax. I understand that I may be contacted for verification.
Please include copies of:
– Recent tax returns or pay statements
– Proof of identity and address
– Additional documentation if necessary.
[Signature of the Applicant]
[Date]
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