Payroll Query Form

Employee Details

Forename(Required)

Surname(Required)

National Insurance Number(Required)

Please enter your National Insurance Number (NINO). This should be in the format ‘AB / 12 34 56 / C’. If you do not have a NINO enter ‘n/a’

Date of Birth(Required)

Address(Required)

Street Address Address Line 2 City County Postal Code Country

This field is hidden when viewing the form

Address

HSCNI Employing Organisation(Required)

Staff Number

Email(Required)

If possible your work email should be used. Please ensure this is correct to help with processing your query.

Contact Number(Required)

Query Details

Sub-category(Required)

Query Subject(Required)

Max. 100 Characters

Query(Required)

File Upload

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 20 MB, Max. files: 5.

Please provide any required documentation. (Uploads should be images or pdf files, Microsoft Office files such as Word or Excel cannot be sent from this form.)