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Salary sacrifice agreement template

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

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What is a Salary sacrifice agreement?

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.

Salary sacrifice agreement template
salary sacrifice agreement template

What legal and best practice aspects should employers be aware of?

  • 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.

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:  


The Salary sacrifice agreement template is issued by an employee
Issue path
The Salary sacrifice agreement template is issued to an employer


To be signed prior to the salary sacrifice being actioned.


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Salary sacrifice policy

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Who are some Companies who utilise our Salary sacrifice agreement template?
Why buy our Salary sacrifice agreement template?
  • You save time and effort with a professionally written, editable HR document that is tailored to meet best practice.
  • You ensure compliance with applicable ACAS Codes of Conduct and other legal requirements.
  • You get a process flowchart to help you adhere to best practice.
  • You are notified by email whenever this template or its supporting resources are updated.
  • You enjoy 12 months of unlimited access with no hidden fees or extra costs.
  • You unlock a 25% discount on all future purchases or renewals of our libraries, toolkits, and templates.

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I have been using the service now for around 6 months and it has been really useful in developing and updating polices and processes.

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