Employer's Payment Record Employer's name Accounts Office reference 931PQ12345678 Demo Employer Limited You will need information about payments when you complete your form P35 (Employer's Annual Return). 2005 Year end 5 April Please enter the details requested each time you make a payment. Enter year Usually, this would be each week or month - when you make the payment.Usually this would be each week or month - when you make the payment. If you make quarterly payments then you would normally record the details every third month. However, you may prefer to enter details for each month(or week) - you should then total them every third month. For guidence on making payments to the HM Revenue & Customs please see Part 3 of employer's Help Book E13 Dat-to-day payroll. Period Income Tax (inc. subcontractor deductions) Student Loan Deductions Tax Credits paid to employee's Net Income Tax (1 + 2 minus 3) Gross National Insurance Contributions (NICs) Statutory Sick Pay (SSP) Statutory Maternity Pay (SMP) NIC compensation on SMP Statutory Paternity Pay (SPP) NIC compensation on SPP Statutory Adoption Pay (SAP) NIC compensation on SAP NIC Holiday claimed Total deductions from NICs Net NICs (5 minus 14) Amount due (4 + 15) Date paid recovered recovered recovered recovered (total of boxes 6 to 13) 1 2 3 4 6 7 8 9 10 11 12 13 14 15 16 17 5 £ £ £ £ £ £ £ £ £ £ £ £ £ £ £ £ £ Month 1 916.21 0.00 0.00 916.21 1,055.53 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,055.53 1,971.74 Month 2 897.24 0.00 0.00 897.24 1,038.87 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,038.87 1,936.11 Month 3 899.07 0.00 0.00 899.07 1,038.87 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,038.87 1,937.94 Quarter 1 2,712.52 0.00 0.00 2,712.52 3,133.27 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3,133.27 5,845.79 Month 4 899.67 0.00 0.00 899.67 1,038.87 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,038.87 1,938.54 Month 5 899.04 0.00 0.00 899.04 1,038.87 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,038.87 1,937.91 Month 6 943.07 0.00 0.00 943.07 1,086.47 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,086.47 2,029.54 Quarter 2 2,741.78 0.00 0.00 2,741.78 3,164.21 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3,164.21 5,905.99 Month 7 943.01 0.00 0.00 943.01 1,086.47 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,086.47 2,029.48 Month 8 943.70 0.00 0.00 943.70 1,086.47 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,086.47 2,030.17 Month 9 943.07 0.00 0.00 943.07 1,086.47 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,086.47 2,029.54 Period Income Tax (inc. subcontractor deductions) Student Loan Deductions Tax Credits paid to employee's Net Income Tax (1 + 2 minus 3) Gross National Insurance Contributions (NICs) Statutory Sick Pay (SSP) Statutory Maternity Pay (SMP) NIC compensation on SMP Statutory Paternity Pay (SPP) NIC compensation on SPP Statutory Adoption Pay (SAP) NIC compensation on SAP NIC Holiday claimed Total deductions from NICs Net NICs (5 minus 14) Amount due (4 + 15) Date paid recovered recovered recovered recovered (total of boxes 6 to 13) 1 2 3 4 6 7 8 9 10 11 12 13 14 15 16 17 5 £ £ £ £ £ £ £ £ £ £ £ £ £ £ £ £ £ Quarter 3 2,829.78 0.00 0.00 2,829.78 3,259.41 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3,259.41 6,089.19 Month 10 943.01 0.00 0.00 943.01 1,086.47 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,086.47 2,029.48 Month 11 943.04 0.00 0.00 943.04 1,086.47 0.00 -349.60 0.00 189.16 0.00 94.58 0.00 0.00 -65.86 1,152.33 2,095.37 Month 12 939.33 0.00 0.00 939.33 1,081.71 0.00 934.36 0.00 0.00 0.00 0.00 0.00 0.00 934.36 147.35 1,086.68 Quarter 4 2,825.38 0.00 0.00 2,825.38 3,254.65 0.00 584.76 0.00 189.16 0.00 94.58 0.00 0.00 868.50 2,386.15 5,211.53 11,109.46 0.00 0.00 11,109.46 12,811.54 0.00 584.76 0.00 189.16 0.00 94.58 0.00 0.00 868.50 11,943.04 23,052.50 Total Complete this line if pay day falls on 5 April(in leap year 4 & 5 April). Record of funding Note If you receive funding from the HM Revenue & Customs to pay Statutory Sick Pay (SSP), Statutory Maternity Pay (SMP),Statutory Paternity Pay (SPP), Statutory Adoption Pay (SAP) or to refund tax, you may keep a record in the table below. It will help you fill in your Employer's Annual Return at the end of the year. The monthly NICs and SSP totals on this form may not be the same as the monthly totals for recovering SSP under the Percentage Threshold Scheme. Date received from HM Revenue & Customs Funding to pay SSP/SMP/SPP/SAP Funding to refund PAYE Income Tax Totals £ £