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ࡱ > ( bjbj 0 e e p l l l l l 8 l $ D 2 }D D D D D D D $ 0G I D l D l l D 0 l l D h }D @ D B P` F EA & D D 0 D kA j tJ R tJ L B tJ l B , 0 " 7 D D D tJ 2 : Information on the new employee
Personnel number:
Personal dataSurname, maiden name as applicable
Given nameStreet and house number (incl. additional information)
Post code, cityDate of birth
Gender ( male
( femaleInsurance number (as per social security card)
Marital statusPlace, country of birth only if without insurance number
Severely disabled ( yes ( noNationality
Employee number, pension fund - construction
Bank account number (IBAN)
Sort code/bank ID (BIC)
EmploymentDate employment contract begins
First dayPlace of employmentDescription of profession
Job performedHighest level of education
No school leaving certificate
Haupt-/Volksschulabschluss (completion of secondary education)
School leaving certificate or equivalent
Abitur/Fachabitur (equivalent of A levels in UK)
Highest level of professional training
No vocational training
Officially recognised vocational training
Master craftsman/technican/equivalent degree
Bachelors degree
Diploma/graduate degree/masters degree/state examination certificate
PhDDate apprenticeship beginsPlanned date apprenticeship endsHoliday entitlement (calender year)
Cost centreWeekly/daily working hours ( full time
( part time
Department numberEmployed in construction industry since
Person groupElectronical acceptance of certificates (Bea)( I object to my income statements (earned and additional) being forwarded electronically to the Bundesagentur fr Arbeit (Federal Employment Office).
Terms of employmentThe term of employment is fixed
The term of employment is fixed for a purposeWritten conclusion of a fixed-term employment contract
Fixed-term employment is planned for at least two months, with prospects of further employmentEmployment contract fixed until
Employment contract concluded on
Taxes - Information as per income tax card Official Municipality/community key
Tax office numberIdentification numberTax class/factor
Number of exemptions for childrenConfession
Social insurance State insurer
Legislated state insurer evaluation
Health insurance | Pension insurance | Retirement insurance | Nursing care insurance
State insurer number
Accident insurance risk tariffParenthood ( yes ( no
CompensationDescription Amount Valid for
Hourly wage Valid fromDescription Amount Valid for
Hourly wage Valid fromDescription Amount Valid for
Hourly wage Valid from
Capital-forming benefits (VWL)Recipient
AmountEmployer share (monthly amount)
Since
Contract numberBank account number (IBAN)
Sort code/bank ID (BIC)
Employment documentsEmployment contract
Income tax card/written confirmation of income tax
Social insurance ID
State insurance membership certificate
Private health insurance certificate
Capital-forming benefits (VWL) contract
Proof of parenthoodAt hand
At hand
At hand
At hand
At hand
At hand
At handCompany retirement provision contract
Declaration of earning for previous employment
For evaluation of insurance exemption regarding health insurance
Severely disabled ID
Pension fund documents construction/paintingAt hand
At hand
At hand
At hand
At hand
Information of taxable previous employment periods in the current calendar year (these are time periods of employment accounted for on the income tax card) Time period fromTime period toType of employmentNumber of employment days
Declaration by the employee:
I affirm that the above information is correct. I undertake to inform my employer without delay of any changes, in particular with regard to further employment (in respect of type, duration and remuneration).
Date Employee signature Date Employer signature
Personnel Questionnaire
(fields with a grey background are to be filled in by the employer)
COMPANY NAME:
PAGE 1Version dated: 10/2014
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