HM Revenue & Customs

Application for Regional Employer NICs Holiday for New Businesses

*indicates required information

Before you start completing this form you MUST ensure you qualify for the Regional Employer National Insurance contributions (NICs) Holiday. Please read the guidance on the HMRC website at: hmrc.gov.uk/payerti/getting-started/nics-holiday/index.htm

Employer details

 Help for Employer PAYE Reference:
 Help for Accounts Office Reference:
 Help for Business name:
 Help for Business start date:
dd/mm/yyyy

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Contact details

Capacity - please enter the capacity below in which you are completing this form. Please tick only one checkbox.

Please note: If you are an agent applying on behalf of your client, a valid form 64-8 must be held by HM Revenue & Customs (HMRC).

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Business location

Please enter details of your main business address and country/region below.

Region. Please tick only one checkbox below to confirm which qualifying country or region the business is located in.

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Declaration

You must agree the following two statements and tick the checkbox below:

  • I confirm I have read all the guidance related to the Regional Employer NICs Holiday for New Businesses available on the HM Revenue & Customs and Business Link websites. This business is not within one of the business sectors to which special State Aid provisions apply and has not been in receipt of any State Aid within the last three years.

  • I confirm that all of the information entered on this application form is correct and I wish to apply for the Regional Employer NICs Holiday for New Businesses.

After you click the ‘Next’ button you will see a preview page summarising the information you have provided. If this page is not displayed please use the scroll bar to locate any missing or incorrect entries highlighted in red.