P11D Questionnaire - AJM Accounting

P11D Questionnaire for Year Ended 5th April 2008

Company Name:

Company Address:

PAYE Tax Reference:

Individual's Name:

Individual's Email Address:

National Insurance Number:

Position:
(i.e. Director or Employee)

Motor Vehicles (Company Cars)

Is the individual or his/her family provided with a car (or cars) available for private use? (i.e. private use includes travel from home to work). If YES, complete an Appendix 1 for each car.

Yes No

Beneficial Loans

Have loans been made to, or arranged for, an individual or his/her family? (includes overdrawn Directors current accounts). If YES, complete Appendix 2.

Yes No

Relocation Expenses

Has the cost of relocating an individual exceeded �8,000?

Yes No

If YES, please provide full details of all expenses.

Other Expense Payments and Benefits

Are payments made on behalf of the individual for the following expenses and benefits? Where the answer is YES, please provide the details of the VAT inclusive costs incurred and the contribution by the individual (if any).

Type of Expense or benefit		VAT inclusive costs	Contribution
a. Private Medical Insurance:	Yes No
b. Private or home telephone:	Yes No
c. Travel and subsistence:	Yes No
d. Vans made available for private use	Yes No
Registration No:
Date first registered:
e. Entertaining:	Yes No
f. Round sum expense allowances:	Yes No
g. Private subscriptions (i.e. golf club, fitness club etc)	Yes No
h. Use of company assets (i.e. house, villa, Yacht, furniture etc). Where computer equipment was provided, identify the cost separately.	Yes No
i. House, flat or other living accommodation:	Yes No
j. Private or other household bills (i.e. newspapers, repairs, gardener, cleaner, nanny etc)	Yes No
k. Any other benefit identified specifically:	Yes No

Appendix 1

Company Cars

Make and model of car:
(i.e. Vauxhall Cavalier GLI 5 door Automatic)

Registration Number:

Date first registered:

CO₂ Emission figure: (If known)

Manufacturers list price at date of first registration (If known)

Details of accessories fitted:

a. At date of first registration:
(i.e. factory-fitted accessories)

b. Since registration if exceeding £100

Has employee contributed to the cost of the car:

a. Capital contribution

b. Contribution for private use (not fuel)

Fuel

Was Fuel provided for Private Use?

Yes
No

If Yes, please provide the following information:

a. Petrol or Diesel

Petrol
Diesel

b. Engine size

1400cc or less
1401cc to 2000cc
Over 2000cc

c. Contribution, if any, by individual for private fuel.
Please state if individual made good the whole cost of private fuel.

Appendix 2

Beneficial Loans

Amount outstanding at 5th April 2004

Amount and Date of Advance if, after 5th April 2004

Amount outstanding at 5th April 2008

Maximum amount outstanding in year

Interest paid by individual

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