Hire Rehire Form

Employee completes Sections 1 to 5 & HR completes Sections 6 to 10
(Please submit original Certificates/Awarding Body Notifications to HR for verification)
When the form is completed, please forward to HR Division.
Note Failure to complete Form may result in non payment
  1. Employment History – To be completed by Employee

Are you now or were you previously employed by the University of Limerick / Yes / No
If Yes, please provide current/previous Personnel Number
Have you attached your P45 to this form? (Tick Yes/ No as appropriate) / Yes / No
  1. Personal Details – To be completed by Employee

Forename: / Surname:
Known As: / PPS Number:
Title: / PRSI Class if Known:
Qualifications: / Phone Number:
Nationality: / Gender: / Male / Female
Date of Birth: / D / D / M / M / Y / Y / Y / Y / Start date: / D / D / M / M / Y / Y / Y / Y
Marital Status: / Single / Married / Other
If Other Please specify. / Number of Dependants:
Spouse Information: / Forename: / Surname:
Spouse Date of Birth: / D / D / M / M / Y / Y / Y / Y / Maiden Name:

Note: 1. Original Qualification Certificates must be sent to HR Division for verification.

2. Originals of Marriage Certificate and Birth Certificate of dependants are required for pension purposes.

3. Completed ICP form to be attached ( contracts > 12 months)

  1. Contact Details – To be completed by the Employee

Home Address:
Telephone Number: / Mobile Number:
  1. Emergency Contact / Next of Kin Details – To be completed by Employee

Forename: / Surname:
Address:
Relationship to Employee (Optional):
Telephone Number: / Mobile Number:
  1. Bank Details – To be completed by Employee

Bank Name / Bank Address
Bank Sort Code / -- / -- / Bank A/C Number

Note: You must sign Declaration below

Hire Rehire Form

Declaration – I confirm that the above information is accurate and correct on the date indicated below. I undertake to notify the HR Division of any changes to this information by completing the appropriate form.

Employee’s Signature ______Date ______

HR completes Sections 6 to 10

  1. Pension Schemes –

Pension Scheme (UL Main Scheme 6.5% includes S & C) / Contract Pensions (UL Defined Contributions Scheme)
Pension Scheme (UL Main Scheme 5.0% - No S & C) / Co-Ordinated Pension (UL Main Scheme – Class A – 3.5% + 1.5% + 1.5%)
Pension Scheme (UL Main Scheme Variable; for Purchase of Notional/Temporary Service) / UL Model Employee Superannuation Scheme
  1. Post Details – To be completed by HR Compensation & Benefit

Personnel
Number / Employee
Name
Management Unit / Department
Job Title
Cost Centre / Status
Sub Status / Category
Sub Category / Location
  1. Basic Pay – To be completed by HR Compensation & Benefit

Incremental Date / D / D / M / M / Y / Y / Y / Y
Contract Hours / FTE Hours / Post Hours
Pay Multiplier / Fixed
Pay Scale / Point on Scale / Annual Salary
  1. PRSI –To be completed by HR

PRSI Class
  1. Contract Elements – To be completed by HR

Contract Type / Valid From / D / D / M / M / Y / Y / Y / Y / Valid Until / D / D / M / M / Y / Y / Y / Y
Probationary Period (If applicable)
Notice Period required from Employee / Notice Period required from Employer
Core Personnel Updated by: / Date
Core Time updated by: / Date

Approved HR ______Date :______

Hire Rehire FormPage 1 of 2 Document Number CF001.8