This form is used to hire or rehire employees in SAP HR. It must be fully completed to avoid delays to salary payments. Personal information, next of kin, employment history, qualifications, professional registration, bank details, and an employee declaration are collected. The hiring manager provides appointment details like the reason for hire, grade, position, and contract type. Failure to complete the form fully could delay salary payments.
This form is used to hire or rehire employees in SAP HR. It must be fully completed to avoid delays to salary payments. Personal information, next of kin, employment history, qualifications, professional registration, bank details, and an employee declaration are collected. The hiring manager provides appointment details like the reason for hire, grade, position, and contract type. Failure to complete the form fully could delay salary payments.
This form is used to hire or rehire employees in SAP HR. It must be fully completed to avoid delays to salary payments. Personal information, next of kin, employment history, qualifications, professional registration, bank details, and an employee declaration are collected. The hiring manager provides appointment details like the reason for hire, grade, position, and contract type. Failure to complete the form fully could delay salary payments.
This form is used to hire or rehire employees in SAP HR. It must be fully completed to avoid delays to salary payments. Personal information, next of kin, employment history, qualifications, professional registration, bank details, and an employee declaration are collected. The hiring manager provides appointment details like the reason for hire, grade, position, and contract type. Failure to complete the form fully could delay salary payments.
This form is to used to hire or rehire employees on SAP HR. Failure to fully complete the form will result in delays to salary payments. Please complete in block capitals & place a tick in the appropriate boxes
Hire Re-hire Permanent Temporary
Personnel Number Start Date
Section 1 - 7 should be completed by Employee/Payee
1. Personal Information Title Mr Mrs Ms Miss Dr Sr. Rev. Fr. Prof.
Surname First Name
Known as Initials
Street Address
Town/City County
Eircode Country
Phone No Mobile Phone No
Email address for online payslip purposes
Former Name Nationality
Date Gender Male Female of Birth
Civil Status Single Married Civil Partnership Widowed Divorced Separated Co-Habiting
PPS Number 2. Next of Kin (Emergency Contact Details) Surname First Name Relationship to you
Street Address
Town/City County
Eircode Country Mobile Phone No
3. Employment History Note: Please ensure P45 / Certificate of Tax Cut Off / PRD45 are forwarded to the appropriate payroll department
Are you currently directly Yes If currently employed by HSE please provide details of your personnel number below employed by HSE/Public Service No
Were you previously employed by HSE / Health Board / Voluntary Hospital / National Hospital/ Public Service Employer? Yes No If No please go to section 4
If previously employed by HSE / Health Board / Voluntary Hospital / National Hospital/ Public Service Employer please provide the following details. (Note: if you have had multiple assignments with these employers please provide details of your latest employment) Name of Employer Last Day of service
Personnel Number Grade
Are you in receipt of a pension under the Local Government Superannuation Scheme or HSE Superannuation Scheme? Yes No If Yes please provide information requested below Name of Authority/ Start Date of Payment Employer
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4. Qualification Details Official use only Proficiency/ Qualification Code Validated Name of Qualification Date from Grade awarded (if applicable) Please () tick one
Yes No
Yes No
Yes No
Yes No
Irish Language Proficiency
Oral Irish Validated - Yes No Written Irish Validated - Yes No
5. Professional Registration Note: only applies to Medical & Dental, Health & Social Care Professionals & Nursing. If this section does not apply to you go to Section 6. If you have multiple registrations please complete Appendix 1 below. Name on Registration Registration Body
Date of Issue Expiry Date
Professional Registration/Membership Number
Visiting EEA Application Status Trainee Specialist Internship Division Specialist Division General Supervised Practitioners (Medical Council) Division Division Division Division 6. Bank Details Bank Bank Address Name Sort Code Account No
Payee Name
Bank Identifier Code (BIC)
SEPA Bank Account No (IBAN)
7. Employee Declaration I declare that the above information is accurate and correct on the date below. I undertake to notify my employer of any changes to this information by completing and submitting the appropriate form.
Signature Date
Appendix 1 Multiple Registrations
Name on Registration Registration Body Date of Expiry Date Issue Professional Registration/Membership Number Name on Registration Registration Body
Date of Issue Expiry Date
Professional Registration/Membership Number
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Section 8 - 15 should be completed by HBS Recruitment/Hiring Manager/Line Manager 8. Appointment Details – Please select reason for Appointment Fill Existing Vacancy Sick Leave Relief Redeployment Fill New Vacancy Urgent Service Needs(Special) SJH Hire Pension Purposes Only Special Project Locum On-Call Relief Agency Subsumed into HSE Student Training Post Locum Relief Temp Appointment from other HSE area N.B. Use HR3 Form Agency Staff Converted to EE Maternity Leave Relief Retiree Replaced Employee Personnel No.
Grade Org Unit No.
Position Number Position Name
Personnel Area Cost Centre
Employee Group Officer Non Officer External Permanent Temporary Employee Sub Wholetime Part-time Casual Fees/ Sessions Group 9. Contract Type – [please attach signed contract] Indefinite Duration Specified Purpose Fixed Term Std T&C’s Specified Indefinite Duration Std T&C’s 06/2014 Fixed Term Std T&C’s 06/2014 06/2014 Purpose Indefinite Duration Fixed Term Specified Purpose Std T&C’s Std T&C’s Std T&C’s Consultant Contract type A B B* C Other Expiry date of Probation period to be served Yes No Temporary Contract nd 1st probationary 2 probationary Review date review date 10. Service year date (for annual leave purposes) Note: Certain grades are entitled to incremental increases to the annual leave entitlement based on length of service in the grade. Please complete the following section so that the correct entitlement may be established.
Is the employee entitled to incremental increases to annual leave, based on length of service? Yes No Nursing Grades Only Years Months Days If yes please enter the number of years, months and days of previous service. Note: Please include all previous service in publicly funded health services in Ireland and relevant nursing experience abroad
Other Grades Years Months Days If yes please enter the number of years, months and days of relevant service at this grade. Note: Please include service if the employee was acting up continuously in the same grade immediately prior to start date
11. Work Pattern
Wholetime Standard hours for this grade Contract Hours for EE (use decimals)
Working Week Mon – Fri 5/5 Mon – Sun 5 / 7 Work Rule Schedule (if casual enter HRPD) Note: Employee works a Monday to Friday roster they are classified as 5/5 & will not receive Sat allowance or Sunday/BH premium. Alternatively if an employee works on Saturday or Sunday they are classified as 5/7 & will be paid the relevant allowances & premium.
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Payroll Frequency Weekly Fortnightly 4 weekly Monthly
Work Location
Allowance Wage Type/Pay Code
Please ensure that supporting Amount/Unit documentation is attached Official Use Only
1 2 13. Pension Details Superannuation classification to be completed in all cases Non New Entrant New HSE Entrant SPSPS
PRSI Class (as per P60) :
Please indicate the relevant Officer Non Officer superannuation scheme PRSI Class A PRSI Class D 1956 Scheme 120 120 200 1977[Revision Scheme] – Main Scheme 160 140 220
Spouses’ & Children’s 320 320 420
Widows’ & Orphan’s N/A 300 400
HSE Employee Superannuation Scheme – Main Scheme (Officer & Non Officers) 165
I declare that the above information is accurate and correct. I confirm that the above employee commenced employment on the date stated above and approve set up on the appropriate HR/payroll system.
Signature Date
Name (Print) Grade
Contact Tel No Decision Number (if applicable)
E-Mail Address
16. Payroll Section
Location Code
Name (Print) Signature
Tel No Date
17. Payroll Interface (phase 1 Only)
Wage Type Entered Employment Signal
Payroll Area Change Details Date
Main Pension Scheme W&O/Spouses Scheme
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PAC Completed Date
Signed Email
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