Deduction from salary form template
Formal template allowing employees to authorise specific salary deductions, ensuring clarity, consent, and HR record-keeping.
Specs:
5 mins to read, 10 mins to prep
193 words, 1 A4 page
Reviewed 4 September 2025
Support:
Legal compliance
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Document sequence
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Deduction from salary form
I, [name], hereby authorise the deduction of £[amount] from my salary each [week | month] in respect of the following:
Examples of deductions may include, but are not limited to:
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Sports and social club subscriptions
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Health and medical insurance (e.g., BUPA, Vitality)
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Pension contributions or additional voluntary contributions (AVCs)
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Legal compliance
An employer should have agreement from an employee to deduct from salary before doing so.
What is this for?
This form allows an employee to formally authorise specific deductions from their salary, such as subscriptions, insurance, pension contributions, charitable donations, or other agreed amounts.
It ensures the deduction is recorded, limits the employer to the stated amount only, and requires written consent for any changes, providing clarity and protection for both employee and payroll.
Document sequence
Pay or salary payment arrangements policy
Our pay or salary payment arrangements policy template provides information regarding pay or salary payment arrangements.
