Staff benefits: SSSCAVC scheme

Your details
Title (Mr, Mrs, Miss, Ms, etc.)
First name
Middle name(s)
Last name
Date of birth (DD/MM/YYYY) Example: 1 May 2008 is 01/05/2008
Payroll number
National Insurance number
Contact email address (work or home)
Contact phone number
Job title
Department
Are you already in the scheme?
Yes, this is a change to my existing arrangementNo, this my first application

Setting up your Prudential account
Please confirm you have completed the necessary steps with Prudential.
I have contacted Prudential and completed the appropriate online application form.
I confirm

Your contribution
As outlined above, this the amount that you want to pay into the scheme (before tax and contributions are deducted) from your monthly salary.
Monthly gross amount (in £) to be paid into SSSCAVC (including £1 contribution)
I have read and understood the information relating to Salary Sacrifice Shared Cost AVC and wish to join/change the amount sacrificed from my salary into the scheme.
I confirm
I agree that the completion and submission of this form constitutes my formal agreement to a reduction of my salary for a minimum of 12 months. My participation or change to the contribution amount in the scheme will begin on the next available payroll date, following receipt and acceptance of my Salary Sacrifice Agreement if required.
I agree

What happens to my information?