Checklist 
Employee Surname 
Employee First Name 
Employment Start Date 
School 
Department 
Position Title 
Description 
Attached (Check to indicate) 
Comments 
Signed Letter of Offer 
Employee Contract - Signed 
Bank Account - Copy of Bank Slip 
or Screen Shot 
Tax Form (IR330) Completed and 
Signed 
Kiwisaver (KS2) Completed 
and Signed 
Identity verification – copy of 
passport 
Copy of visa (if applicable) 
Verified Qualifications (Must be 
attached if applicable) 
Date : 
HR Name : 
HR  Signature : 
Date : 
Manager Name : 
Manager Signature : 
Please note if the information provided is not accurately completed, signed and attached - payroll 
will reject the application until the appropriate information is given, unless with valid reasoning. 

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Document Outline

• Use this form if you’re receiving salary or wages as an employee.
• 1 Your details
• 2 Your tax code
  • Choose only ONE tax code Refer to the flowchart on page 2 and then enter a tax code here.
• 3 Declaration
• Salary and wages – main or highest source of income
  • Yes
  • Yes
  • No
  • Yes
  • Yes
  • No
  • N
  • Yes No
  • M
  • Yes No
• Secondary income
  • No
  • Yes
  • No
  • SB SL
• Other tax code options:
  • Yes
  • No S
  • No
  • No
  • No Yes
  • SH
  • STC
    • Important: You may need to change your tax code if your circumstances change during the year. For example:
    • – start or stop being eligible to use ME or ME SL (see note 5 below)
• Notes to help you complete this form
  • Please read the notes on the back to help you fill in this form
  • Please give this completed form to your employer
  • Starting new employment
  • Joining KiwiSaver if you’re a new employee 65 or over
  • Existing employees who want to become KiwiSaver members
  • Joining KiwiSaver if you’re under 18
  • Existing KiwiSaver member
  • Contribution rate
  • Privacy
  • ird.govt.nz/kiwisaver

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