Salary sacrifice agreement template

12 months unlimited access:
£ 15

Our Salary Sacrifice Agreement establishes a clear and formal arrangement for employees to voluntarily exchange part of their salary for specific benefits or contributions.

Why this template is necessary

This Salary Sacrifice Agreement facilitates the formal agreement between an employer and an employee regarding salary sacrifice arrangements.

It outlines the terms, benefits, and implications of reducing an employee's salary for non-cash benefits like pensions or childcare vouchers.

The purpose is to ensure clear understanding and compliance with agreed-upon adjustments, promoting a transparent and mutually beneficial arrangement.

  • Income Tax (Earnings and Pensions) Act 2003: Defines the tax treatment of salary sacrifice arrangements and benefits.

  • National Minimum Wage Act 1998: Ensures that salary sacrifice does not result in employees earning less than the minimum wage.

  • Equality Act 2010: Prohibits discriminatory practices in salary sacrifice agreements based on protected characteristics.

  • Pensions Act 2008: Regulates pension contributions, including those made through salary sacrifice.

  • Data Protection Act 2018 (incorporating GDPR): Requires personal data shared in salary sacrifice forms to be handled according to data protection principles.

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Salary sacrifice policy

Our salary sacrifice policy template outlines the guidelines and procedures for employees opting into salary sacrifice schemes, promoting transparency and compliance with relevant regulations.

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Salary sacrifice agreement template


Reading time icon
Time to read / prep / use
5 mins
Document specs icon
Word count / length
226 words, 1 page A4
Date last reviewed icon
Date last reviewed
1 July 2024
salary sacrifice agreement template

Salary sacrifice agreement

Employee Information

Full Name:  
Job title:  

Salary Sacrifice Benefit Details

Chosen Benefit:  
Start Date of Arrangement:  
Duration of Arrangement:  
Amount to be Sacrificed (per pay period):  
Total Amount to be Sacrificed (if applicable):  
Brief Description of Chosen Benefit:  
Agreement Period (if different from Start Date):  
Any Specific Conditions or Notes:  

Tax and Financial Implications Acknowledgment

I understand that participating in the salary sacrifice arrangement may have tax and National Insurance contributions implications. I acknowledge that I have been advsed that I may wish to seek independent financial advice to understand the potential impact on my personal financial situation.


By signing this form, I agree to the terms and conditions outlined in the Salary Sacrifice Policy. I confirm that the information provided in this form is accurate to the best of my knowledge.

Employee Signature:  

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Why choose our Salary sacrifice agreement template?

Our content:

Is easy to edit and execute, with comprehensive implementation guidance.
Is designed by accredited, experienced HR practitioners.
Maintains your compliance with ACAS guidelines, legislation, and industry best practices.
Includes 12 months access to your purchase, with email alerts if updated or expanded.

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