Settlement Agreement Instructions Form

Name of Person Completing this Form:

Email address of Person Completing this Form *

Legal Name of Employer

This must be the name of a real person or persons, or a registered company or limited liability partnership.

Full Name of Employee

Employee's Address

Employer's Registered Address:

If the Employer is a limited company or LLP, the registration number as per Companies House:

Use this to search if in doubt: https://find-and-update.company-information.service.gov.uk

If the Employer is part of a group of companies which should be included in the settlement agreement, list the group entities here:

Note: this is only necessary where there are potential claims against group companies or their employees.

Background

Employee's most recent Job Title:

Date of Contract of Employment:

Date on which Employee's continuous employment commenced:

Arrangements on Termination

the is Employee

Agreed termination will be…

After the notice period, which will be worked as normal
After the notice period, which the employee will not be required to work
With effect immediately, or soon thereafter, with pay in lieu of notice

Pay in lieu of accrued but untaken annual leave

Please either say how may days are accrued, or say how many days entitlement the employee has per annum, how many have been taken in the current leave year (including bank holidays) and confirm when the leave year commenced.

Identify all that will apply:

Employee to submit outstanding expenses claim
Use of company credit card for non business expenses to be deducted from outstanding pay
Other deductions to be made from final pay

If any benefits will continue after termination please identify these and the date on which they will cease:

Termination Payment and Contribution to Legal Fees

Amount to be paid as compensation:

When will compensation be paid?

e.g. within a certain number of days of the termination date

Contribution to Employee's Legal Fees for Sign Off Advice:

Note: this is usually between £350 and £550 plus VAT and is paid by the Employer because it is necessary for the settlement to be legally binding.

Reference and Announcement

If a reference is agreed please include the text of it below:

Standard reference reads: “I write further to your letter requesting a reference for our former employee. I confirm that EmployeeName started employment with EmployerName on Date and was employed most recently as a JobTitle . EmployeeName left hisher employment with us with effect from Date to pursue other opportunities. EmployeeName received a basic salary of £ Amount per annum plus bonuses. We recommend EmployeeName for any position commensurate with hisher talents and experience. This reference is given to the addressee in confidence and only for the purposes for which it was requested. It is given in good faith, but neither the writer nor our organisation accepts any responsibility or liability for any loss or damage caused to the addressee or any third party as a result of any reliance being placed on it.”

If an announcement to other employees is agreed please include the text of it below:

Standard announcement reads: “EmployeeName has left EmployerName to pursue other opportunities. We wish himher the very best for hisher future.”

Post Employment Restrictions

If the Employee's contract contains post employment restrictions which are to remain in force, copy the text of the same below: