Malvern Hills Attachment of Earnings Acknowledgement Form

1) Name of the person the Attachment of Earnings Order has been issued against*

First NameLast Name

2) Council Tax Account Number (9 digits located on this notification)*

3) Is the person named on the order employed by you or your organisation

YesNo

If yes, please confirm if you will be able to make deductions under this attachment of earnings request

YesNo

Can you confirm that you are able to commence deductions against this the attachment of earnings order

YesNo

Can you confirm the average earnings of your employee and when the deductions can commence

If you have answered no to question 3, please complete the below:

The person named on the order has never worked for usThe person names on the form no longer works for us

Can you advise where the named person is now employed?

YesNo

Does the person name on the order have earnings that are below the threshold for deductions?

YesNo

Other priority deductions are currently in place

YesNo

4) Employee job role/title*

5) Employee payroll number or NINO

6) The full name of your business/organisation*

7) Your full name*

First NameLast Name

8) Your position in the company*

9) Your email address*

example@example.com

10) Contact Phone Number*

Area CodePhone Number

Further information

Declaration and use of personal information

By clicking submit you agree to Malvern Hills District Council using your personal information for the purposes of processing your attachment of earnings acknowledgement form and any other activity related to your form. We will not use your information for any other purpose or share it with anyone outside of the council.

Your personal information will be processed in accordance with our Privacy Notice.