Email Payslip Form

PLEASE WRITE IN CAPITALS AND USE INK

Name:	____________________________________
NI Number:	____________________________________
Email address (where your payslip/s will be sent):	_________________________________________
Password: (you will need to enter a password to open your payslips) 6-8 characters only	____________________________________
Signed:	____________________________________
Date:	____________________________________

Please return ASAP

D&R Business Solutions

1 Vale Parc

Colomendy Industrial Estate

Denbigh

Denbighshire

LL16 5TA

Tel: 01745 813300

Fax: 01745 774922

** Please note the email address you provide must not be a work related address