Please complete all sections in CAPITAL LETTERS and return to us with

Thornberry PSC Registration Form your signature.

Your Personal Details
Profession .............................................
Home Address .............................................
Gender .............................................
Post Code .............................................
Title .............................................
Your choice of company name...............................................
First Name .............................................
Email Address .............................................
Other Names .............................................
Marital Status .............................................
Surname .............................................
Place of Birth .............................................
Date of Birth .............................................
How Did You Hear .............................................
Mobile Number .............................................
About Us? ..............................................
Home Telephone Number .............................................
Nationality (on your passport .............................................
NI Number .............................................
Do you have a P45 from your previous employer? Yes / No
I have enclosed my original P45 from my previous employer Yes / No
I do not have a P45 and so have completed and enclosed my original P46 Yes / No
Please enclose clear copies of your proof of identity and entitlement to work in the UK, certified by any Bank, Solicitor, Doctor, Accountant, Civil Servant
etc. This may be as follows (please confirm your option of choice):
A current UK passport and a recent utility bill / bank statement
A current passport showing you are an EU national and a recent utility bill / bank statement
A current passport showing you are entitled to stay and do any kind of work in the UK and that you are exempt from
Immigration control, allowed to stay indefinitely in the UK, have the right of abode in the UK or no time limit on your stay
(include all relevant pages) and a recent utility bill / bank statement
We will automatically provide our full accountancy and administration package, however, we will provide a completely bespoke service to you if you
prefer. If so, just give us a call and well talk through your options.
Your Agency / Client Details If theyre not confirmed, just leave this bit blank
Agency Name ............................................. Branch Location.............................................
Consultant Name ............................................. Branch Phone Number.................................
Consultant Email ............................................. Start date of assignment...............................
Rate ..............................................Per Hour/ Day End date of assignment................................
How would you like to receive your income? Payroll Frequency.........................................
Minimum Wage and Dividends Yes / No NI Threshold and Dividends Yes / No
Salary and Dividends Yes / No Amount ............ All Salary Yes / No
Your Bank Account Details Youll need a business account once youre limited company is all set up well help with this.
Bank Name .............................................
Account Number.............................................
Branch Location .............................................
Sort Code ..........................................
Name of Account .............................................
Building Society Reference............................
Insurances
Limited COmpanies are required to maintain their own insurance policies. If you would like us to assist you,
please tick here. If you already have insurances, please include your policy documentation.
Signatures and Declarations
I confirm that I have sought professional advice tailored for me individually. I have received, read and understood and agree to accept the terms and conditions of
agreement provided to me and have signed and returned them with this application form, as well as any corresponding policy and procedures. I certify that the
above details are complete and correct. I have selected Thornberry UK PSC as my service provider and as such instruct Thornberry UK to set up my limited
company (PSC) in accordance with the laws of England and Wales. I also request that you assist me with sourcing professional partners, including, if required, the
setting up of a business bank account linked to my PSC. I also instruct Thornberry UK to submit an electronic APO1 and 64-8 form on my behalf to the relevant
authorities.
I understand that I am the sole director and shareholder of my PSC, and that I am solely responsible for it and all transactions, and will instruct Thornberry UK of
my wishes accordingly. Thornberry UK will have no involvement with the finances of my PSC whatsoever and will have no powers of signing over any
documentation or bank account transaction.
I confirm that I consent to Thornberry UK and its business partners using my personal information, including sensitive personal data in accordance with legislation.
I wish to be updated as to your news and events via email and SMS to the email address and mobile number I have provided to you, and my preferred method of
communication is electronic.
Signed ..............................................................................................

Dated ..............................................................................................