Job Retention Scheme DB Form

06.05.2020

1 Step 1

Job Retention Scheme DBJRSDB1

First Name

Last Name

Your E-mail Addressa valid email

Your Personal Security PIN (Minimum of 6 characters alphanumeric)

Submission Tracking

Claim reference number

Date claim submitted

Date claim money received

Corporation Tax Unique Taxpayer Reference

Self Assessment Unique Taxpayer ReferenceSelf Assessment Unique Taxpayer Reference

Name of employer

Claim start date

Claim end date

How many employees have been furloughed in the period you're claiming for?

Gross furlough amount

Employer National Insurance contributions

Employer minimum pension contributions

Employee Details

Enter Number of Employees

Employee 1

Full Name

National Insurance Number

Payroll Number (Optional - This is the RTI Pay ID)

Employee 2

Full Name

National Insurance Number

Payroll Number (Optional - This is the RTI Pay ID)

Employee 3

Full Name

National Insurance Number

Payroll Number (Optional - This is the RTI Pay ID)

Employee 4

Full Name

National Insurance Number

Payroll Number (Optional - This is the RTI Pay ID)

Employee 5

Full Name

National Insurance Number

Payroll Number (Optional - This is the RTI Pay ID)

Employee 6

Full Name

National Insurance Number

Payroll Number (Optional - This is the RTI Pay ID)

Employee 7

Full Name

National Insurance Number

Payroll Number (Optional - This is the RTI Pay ID)

Employee 8

Full Name

National Insurance Number

Payroll Number (Optional - This is the RTI Pay ID)

Employee 9

Full Name

National Insurance Number

Payroll Number (Optional - This is the RTI Pay ID)

Employee 10

Full Name

National Insurance Number

Payroll Number (Optional - This is the RTI Pay ID)

Bank Details - Where the Claim money is to be sent

Sort Code

Account Number

Building society roll number (if you have one)

Bank address

Contact - Who HMRC need to contact the employer about this claim

Full Name

Telephone Number

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