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Salary sacrifice termination or changes form template

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Our Salary Sacrifice Termination or Changes Form allows employees to request adjustments or cessation of their salary sacrifice arrangement, ensuring clear communication and proper record-keeping.

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What is a Salary sacrifice termination or changes form?

This Salary Sacrifice Termination or Changes Form facilitates the process of recording and formalizing any changes or termination of a salary sacrifice arrangement.

It captures details about the employee, the specific benefit being modified, the effective date of the change, and the reason for the adjustment or termination.

The purpose of this form is to ensure accurate documentation, adherence to legal requirements, and clear communication between the employee and the employer regarding any alterations to the salary sacrifice arrangement.

Salary sacrifice termination or changes form template
salary sacrifice termination or changes form template

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

When implementing a Salary Sacrifice Termination or Changes Form, it's important to be aware of key UK employment legislations. Here are some of the essential ones:

  • Income Tax (Earnings and Pensions) Act 2003: This legislation provides the necessary framework for addressing tax implications when terminating or making changes to a salary sacrifice arrangement, ensuring that the process is aligned with tax regulations.

  • Employment Rights Act 1996: The form and its associated process must comply with the stipulations of this act, guaranteeing that employees' rights are respected, and their obligations are communicated transparently when salary sacrifice arrangements are altered or terminated.

  • Equality Act 2010: Changes or terminations communicated through the form should adhere to the principles of fairness and equality enshrined in this act, preventing any discriminatory practices and ensuring that all employees are treated equally in the process.

  • Pensions Act 2008: In the event that the salary sacrifice arrangement involves pension contributions, the form and its process should follow the guidelines outlined by this legislation, particularly regarding the treatment of pension benefits during changes or terminations.

  • Data Protection Act 2018 (incorporating GDPR): As personal data may be involved in the form, it's essential that the handling of such data during the termination or changes process aligns with the data protection principles set forth by this legislation, ensuring the security and confidentiality of employees' information.

Salary sacrifice termination or changes

Employee Information

Full Name:  
Job title:  

Request Type:

Termination of Salary Sacrifice Arrangement

Changes to Existing Salary Sacrifice Arrangement

Existing Benefit Details

Chosen Benefit:  
Start Date of Arrangement:  
Duration of Arrangement:  
Amount Currently Sacrificed (per pay period):  

Proposed Changes (if applicable)

Chosen Benefit:  
Proposed Date of Changes:  
Revised Duration of Arrangement:  
Revised Amount to be Sacrificed (per pay period):  
Brief Explanation of Changes:  

Reason for Termination or Changes

[Please provide a brief explanation for your request.]



By signing this form, I confirm that the information provided is accurate and that I understand the implications of terminating or changing my salary sacrifice arrangement. I understand that any changes will be processed in accordance with company policies and UK regulations.

Employee Signature:  

Version: [1.0]

Issue date: [date]


The Salary sacrifice termination or changes form template is issued by an employee
Issue path
The Salary sacrifice termination or changes form template is issued to an employer


As and when required.

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