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How do I fill this out?
To fill out this form, start by providing your personal details. Next, state the dates of your sickness and any relevant information. Finally, review your entry carefully before submitting it to your employer.

How to fill out the Statutory Sick Pay (SSP) Employee Statement?
1
Provide your surname, first name, and title.
2
Fill in your National Insurance number and date of birth.
3
Enter details about your sickness and relevant dates.
4
Complete the signature section and add your contact number.
5
Submit the form to your employer.
Who needs the Statutory Sick Pay (SSP) Employee Statement?
1
Employees who have been sick for four or more consecutive days.
2
Workers seeking to claim Statutory Sick Pay from their employer.
3
Individuals needing to document their sickness for employer records.
4
Employees who experienced work-related accidents or industrial disease.
5
Anyone who might be eligible for Employment and Support Allowance.
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1
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2
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What are the instructions for submitting this form?
To submit the SSP form, give the completed document directly to your employer. Ensure you retain a copy for your records for future reference. It might be beneficial to confirm with your employer's HR department to understand their specific submission process.
What are the important dates for this form in 2024 and 2025?
In 2024, ensure that your SSP claims are submitted promptly as per employer deadlines throughout the year. For 2025, dates are yet to be confirmed but keep an eye on government updates regarding any changes in policy or requirements for claiming SSP.

What is the purpose of this form?
The purpose of the Statutory Sick Pay (SSP) Employee Statement is to provide a formal declaration of an employee's sickness. This form enables employers to determine eligibility for SSP payments. By requiring necessary personal and sickness details, it streamlines the process of claiming financial support for employees unable to work due to illness.

Tell me about this form and its components and fields line-by-line.

- 1. Surname or Family Name: The last name of the employee.
- 2. First Name(s): The first name of the employee.
- 3. Title: Title such as MR, MRS, MISS, MS.
- 4. National Insurance Number: The employee's unique National Insurance identifier.
- 5. Date of Birth: The birth date in the specified format.
- 6. Sickness Details: Information regarding the employee's illness.
- 7. Sickness Start Date: Date when the employee's sickness began.
- 8. Sickness End Date: Date when the employee's sickness ended.
- 9. Last Worked Date: Last date on which the employee worked.
- 10. Finish Time: Time the employee finished work before the sickness.
- 11. Accident Details: Indicate if the sickness was due to an accident at work.
What happens if I fail to submit this form?
Failing to submit the SSP form can lead to delays in receiving financial support while you are sick. Your employer needs this document to decide on your eligibility for Statutory Sick Pay. If the form isn't submitted, you may miss out on the benefits essential for recovery.
- Delay in SSP Payments: Not submitting may postpone your required financial aid.
- Employer Notification: Failures in submission can lead to employers being unaware of your sickness status.
- Employment Rights: Proper submission is necessary to protect your employment rights regarding sick leave.
How do I know when to use this form?

- 1. Claiming SSP: To formally claim Statutory Sick Pay from your employer.
- 2. Sickness Documentation: To document the sickness duration for employment records.
- 3. Work-Related Incidents: To report injuries or diseases incurred at the workplace.
Frequently Asked Questions
What is the purpose of the SSP form?
The SSP form is designed for employees to report their sickness to claim Statutory Sick Pay.
How do I submit the form?
You can submit the completed form directly to your employer for processing.
Can I edit my PDF before submission?
Yes, PrintFriendly allows you to make edits to your PDF before you download it.
How do I fill out the form correctly?
Ensure all your personal details and sickness information are accurately filled out.
What happens if I don't fill out the SSP form?
Not submitting the form may result in your employer not processing your SSP claim.
Is there support for filling out this form?
Yes, you can seek assistance from your HR department or utilize resources from the DWP.
What if my sickness lasts longer than seven days?
You might need to provide a medical statement from your doctor.
Where can I find more information about SSP?
You can find additional information on the government website regarding Statutory Sick Pay.
Can I use the form for any type of sickness?
The form is specifically for conditions that prevent you from working.
Can I print the edited PDF from PrintFriendly?
Definitely! After editing, you can print your finalized PDF directly.
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