EMPLOYEE SSP1 INFORMATION About an employee Surname : Archer Forename : Jerrry Second Forename : NINO : NA Works No. : 11 Tax Reference No 1185L Address Oxford UB8 2RR United Kingdom   I am filling in this form because I cannot pay you SSP I cannot pay you SSP after 03 / Jun / 2008 I cannot pay you SSP Because A You claimed Incapacity Benefit or severe Disablement Allowance during the last 8 weeks or you are entitled to the 52 weeks benefit protection so you may be able to get incapacity Benefit or severe Disablement Allowance Instead of SSP. B Your contract of employment has expired. C Your contract of employment has been brought to an end. You will soon have been getting SSP for 28 weeks or you have already had SSP for 28 weeks. D E You have not earned enough money to qualify for SSP. You are aged 65 or over. F You are expecting a baby soon or you have just had a baby. G You have already been sick on and off for 3 years. H You were away from work because of a trade dispute on the first day you were sick.. I You were in legal custody or you were serving a term of imprisonment when you became sick. or you are now in legal custody or sentenced to a term of imprisonment. J Y You were working outside the UK on the day you first became sick and I was not liable to pay employer's Class 1 NI Contributions on your earnings on that day. K You have not started working for me yet. L   The employee's first day's of sickness The first day of sickness or first day of linked spell. 03 / Jun / 2008 About the SSP that has been paid. 0 weeks 0 days   How many qualifying days are there in a week ?   1 days     Please tick which days of the week the employee works.     Y Monday Y Tuesday Y Wednesday Y Thursday Y Friday   N Saturday N Sunday             Provide dates of all periods of sick absences from the first date of sickness, in the current period of incapacity for Work(PIW). From To 09 / Jun / 2008 03 / Jun / 2008   Employer's declaration Employer's Name : Robert Redford Employer's Account Office reference number 931PQ12345678 Date : 23/08/2018 Telephone No. : 0161 1234 567 Fax No. : Employer's Address : Network House Arundel Road Uxbridge Industrial Estate Uxbridge UB8 2RR United Kingdom