IE
S.I. No. 197/2003 - Protection of Employees (Employers' Insolvency) (Forms and Procedure) (Amendment) Regulations 2003
Table of Provisions (9)
Statutory Text (9 Articles)
1. When making an initial claim to the Insolvency Payments Section on behalf of the former employees of an Insolvent Company, copies of the following documentation must be attached
(a) Notice of appointment of Liquidator/Receiver
(b) Statement of Affairs/Accounts
2. Initial claims for each employee should be accompanied by a copy of the employee's P45 or written confirmation of his/her class of insurance.
3.
PLEASE NOTE THAT FAILURE TO COMPLETE THE FORM FULLY MAY RESULT IN DELAY IN MAKING THE PAYMENT.
DETAILS OF INSOLVENT COMPANY
Employer's PAYE Registered No.
Figures
Letters
Name of company
Business Address
Nature of Business
Names of Directors and Company Secretary
PPS No.
% Shareholding
Figures
Letters
Date of Insolvency
Day
Mth
Year
Type of Insolvency
RELEVANT OFFICER CERTIFICATE
Name of Relevant Officer
Name of Company
Business Address
Telephone No. (including area code)
Relevant Officer Tax No.
Figures
Letters
Please attach a schedule of employee entitlements. Annex EIP3(a) attached shows the format required. Please ensure that your schedule is clearly headed by the company name and PAYE No.
No. of pages of Annex EIP3(a) attached
Declaration
To: Minister for Enterprise, Trade and Employment
In connection with the provisions of the Protection of Employees (Employers' Insolvency) Acts, 1984-2003, I have accepted and certify, based on the best information available to me, the entitlement of the employees as shown on the attached schedule. I have made no other application in respect of these entitlements. I understand that it may be necessary for you to refer information on the entitlements to the Revenue Commissioners and/or to other Government Departments. I hereby give my consent to the disclosure of such information as is in my possession. I also agree to make available to you such records as may be required for examination. I undertake to distribute the appropriate amounts to the employees concerned from the funds received pursuant to this application. Copies of employee claims are on the relevant forms are attached.
I declare that the company is insolvent and that there are no funds available from which the entitlements claimed on the attached schedule can be paid.
The Instrument of payment should be drawn in favour of (Relevant Officer)
Address
Signature of Relevant Officer
Date
Department of Enterprise, Trade and Employment
Tel: (01) 6312121
Davitt House
Fax: (01) 6313217
65a Adelaide Road
Web: www.entemp.ie
Dublin 2
Lo-call 1890 220222
Schedule of Employee Entitlements
Form EIP3
Company Name
PAYE No.
Annex (a)
Employee's Name
PPS No.
Total Arrears of Wages
Deductions (Union dues, VHI/BUPA, etc.)
Total Arrears of Holiday Pay
Total Arrears of Sick Pay
Total Minimum Notice
Total of Columns (c), (d), (e), (f) & (g)
(a)
(b)
(c)
(d)
(e)
(f)
(g)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Total
€
Employee's Name
PPS No.
Employment Equality Act, 1998
Unfair Dismissals Act, 1977, Court Awards in respect of Unfair or Wrongful Dismissals
Maternity Protection Act, 1994, Adoptive Leave Act, 1995, Parental Leave Act, 1998
National Minimum Wage Act, 2000
Statutory Minimum Wages Under an Employment Regulation Order
Total of Columns (j), (k), (l), (m) & (n)
(h)
(i)
(j)
(k)
(l)
(m)
(n)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Total
€
GIVEN under my hand,
22 May 2003
FRANK FAHEY
Minister of State at the Department of Enterprise, Trade & Employment
EXPLANATORY NOTE
(This note is not part of the Instrument and does not purport to be a legal interpretation.)
The purpose of these Regulations is to prescribe revised forms and certificates to be used in connection with the submission of claims under Section 6 of the Protection of Employees (Employers' Insolvency) Acts, 1984 to 2003.
3. A separate Form EIP1 should be completed where payment is being claimed in respect of Arrears of Wages, Sick Pay, Holiday Pay or Minimum Notice.
4. Claims in respect of statutory minimum wages can only be made in respect of employments covered by an Employment Regulation Order. In case of doubt about the application of an Employment Regulation Order, claimants should contact the Labour Inspectorate Section of this Department.
5. Please attach a copy of the Recommendation, Determination or Order as appropriate, if available.
6. PLEASE NOTE THAT FAILURE TO COMPLETE THE FORM FULLY MAY RESULT IN DELAY IN MAKING THE PAYMENT.
Department of Enterprise, Trade and Employment
Tel: (01) 6312121
Davitt House
Fax: (01) 6313217
65a Adelaide Road
Web: www.entemp.ie
Dublin 2
Lo-call 1890 220222
Part 1 Your Details
(Please complete in Block Capitals)
Figures
Letters
Employee's PPS No.
Employee's Surname
Employee's First name
Employee's Address
Date of Birth
Day
Month
Year
Class of Insurance
Please attach copy of P45 if available
Part 2 Employer Details
Name of Employer
Employer's Address
Type of Business
(e.g., clothing manufacturer)
Name of Receiver/Liquidator/Employer Representative
Telephone No.
(Including area code)
Part 3 Employment Details
Occupation
Date of Commencement of employment
Day
Month
Year
Date of Termination of employment
Day
Month
Year
Gross Pay
€
Week
€
Month
or
No. of days and hours normally worked per week
Days
Hours
Director
Secretary
Shareholder
If you were a Director, Secretary or Shareholder of the Company, please indicate as appropriate
Part 4 Employment Equality Act, 1998
Date
Has an appeal been lodged? Yes/No
Day
Mth
Year
Amount
Reference No.
Equality Officer Decision
€
Mediated Settlement
€
Labour Court Determination
€
Civil Court Award/Order
€
Note: Please attach copy of decision, mediated settlement, determination or award/order, as appropriate. Date refers to date of decision, settlement, etc.
Part 5 Unfair Dismissals Act, 1977, or Court Awards in respect of Unfair or Wrongful Dismissal
Date
Has an appeal been lodged? Yes/No
Day
Mth
Year
Amount
Reference No.
Rights Commissioner Recommendation
€
Employment Appeals Tribunal Determination
€
Civil Court Award/Order
€
Note: Please attach copy of recommendation, determination, award or order, as appropriate. Date refers to date of recommendation, determination, etc
Part 6 Maternity Protection Act, 1994, Adoptive Leave Act, 1995 or Parental Leave Act, 1998
Please tick as appropriate
Maternity Protection Act, 1994
Adoptive Leave Act, 1995
Parental Leave Act, 1998
Date
Has an appeal been lodged? Yes/No
Day
Mth
Year
Amount
Reference No.
Rights Commissioner Recommendation
€
Employment Appeals Tribunal Determination
€
Civil Court Award/Order
€
Note: Please attach copy of recommendation, determination, or award/order, as appropriate. Date refers to date of recommendation, determination, etc.
Part 7 National Minimum Wage Act, 2000
Note: A claim under this part is not payable unless proceedings against the employer under
Section 45
(1) of the
Industrial Relations Act, 1946
, for the amount involved have been instituted.
Date
Has an appeal been lodged? Yes/No
Day
Mth
Year
Amount
Reference No.
Rights Commissioner Decision
€
Labour Court Determination
€
Civil Court Award/Order
€
Note: Please attach copy of decision, determination or award/order, as appropriate. Date refers to date of decision, determination, etc.
Part 8 Statutory Minimum Wages under an Employment Regulation Order
Title of Employment Regulation Order
Have proceedings been instituted against the employer? (please tick appropriate box)
Yes
No
If Yes, by whom?
In which Court? (If applicable)
State the period in respect of which the claim is being made
From
To
Day
Mth
Year
Day
Mth
Year
Total No. of Weeks
Gross Weekly Pay
€
Total Claimed
€
I apply for payment due to me under the Protection of Employees (Employers' Insolvency) Acts 1984-2003 and declare that I have made no other applications in respect of the amounts shown above. I am aware that my rights and remedies against my employer in respect of these amounts will be transferred to the Minister for Enterprise, Trade and Employment when payment has been made. I also declare in respect of the amounts claimed above that I have made no appeal in respect of these amounts and I am not aware, to the best of my knowledge, that these amounts are the subject of appeal by someone else.
Signature:___________________________________________
Date:________________________________
WARNING: LEGAL PROCEEDINGS MAY BE TAKEN AGAINST ANYONE MAKING A FALSE STATEMENT ON THIS FORM
PART 3
Form EIP3
Department of
Enterprise, Trade
and Employment
Insolvency Payments Scheme
Protection of Employees (Employers' Insolvency) Acts, 1984-2003
APPLICATION BY A RELEVANT OFFICER FOR FUNDS IN RESPECT OF
WAGES, HOLIDAY PAY, SICK PAY, MINIMUM NOTICE ENTITLEMENTS/ AWARDS, ENTITLEMENTS UNDER THE EMPLOYMENT EQUALITY ACT, 1998, UNFAIR DISMISSALS ACT, 1977, COURT AWARDS IN RESPECT OF UNFAIR OR WRONGFUL DISMISSAL, MATERNITY PROTECTION ACT, 1994, ADOPTIVE LEAVE ACT, 1995, PARENTAL LEAVE ACT, 1998, NATIONAL MINIMUM WAGE ACT, 2000 AND STATUTORY MINIMUM WAGES UNDER AN EMPLOYMENT REGULATION ORDER.
NOTE: PLEASE READ NOTES BELOW BEFORE COMPLETING THIS FORM
7. Deductions for union dues, VHI/BUPA, etc. which were made from gross wages and not paid over to the appropriate authority should be inserted in Part 4.
8. In the case of sick pay, payment will not exceed the difference between any social welfare benefit payable and gross weekly pay.
9.
PLEASE NOTE THAT FAILURE TO COMPLETE THE FORM FULLY MAY RESULT IN DELAY IN MAKING THE PAYMENT
Department of Enterprise, Trade and Employment
Tel: (01) 6312121
Davitt House
Fax: (01) 6313217
65a Adelaide Road
Web: www.entemp.ie
Dublin 2
Lo-call 1890 220222
Part 1 Your Details
(Please complete in Block Capitals)
Figures
Letters
Employee's PPS No.
Employee's Surname
Employee's First name
Employee's Address
Date of Birth
Day
Month
Year
Class of Insurance
Please attach copy of P45 if available
Part 2 Employer Details
Name of Employer
Employer's Address
Type of Business
(e.g., clothing manufacturer)
Name of Receiver/Liquidator/Employer Representative
Telephone No.
(Including area code)
Part 3 Employment Details
Occupation
Date of Commencement of employment
Day
Month
Year
Date of Termination of employment
Day
Month
Year
Gross Pay
€
Week
€
Month
or
No. of days and hours normally worked per week
Days
Hours
Director
Secretary
Shareholder
If you were a Director, Secretary or Shareholder of the Company, please indicate as appropriate
Part 4 Arrears of Wages Pay
If you are owed wages, overtime, bonus or commission payments, give details in the spaces provided.
If wages claim includes “bounced” cheques, please attach cheques. In relation to overtime and commission, please see Note 6.
Type
From
To
No. of weeks/days
Gross weekly wage
Amount Due
(wages, bonus, etc.)
Day
Mth
Year
Day
Mth
Year
(Actual)
€
€
€
€
€
€
€
€
Average (if required) (See Note 6)
€
Total Arrears of Wages Claimed
€
Deductions from Wages, e.g., Union Dues, VHI/BUPA, etc.
Type
From
To
No. of weeks
Weekly Deduction
Amount Due
Day
Mth
Year
Day
Mth
Year
€
€
€
€
€
€
€
€
Total Arrears of Deductions Claimed
€
Part 5 Arrears of Holiday Pay
From
To
Total no of weeks due (incl. public holidays due)
Day
Mth
Year
Day
Mth
Year
Annual Leave Entitlement
No. of days
Annual Leave Taken
No. of days
Public Holidays Due
No. of days
Gross Weekly Pay
€
Arrears of Holiday Pay Claimed
€
Part 6 Minimum Notice
No. of Weeks' Notice Due/Awarded
Gross Weekly Pay
€
Total Amount of Minimum Notice Claimed
€
If claim is in respect of an Employment Appeals Tribunal Award, please attach copy of the Tribunal Award and complete the following
Day
Month
Year
Date of Employment Appeals Tribunal Award
Reference Number of Award
Part 7 Arrears due under a Company Sick Pay Scheme
From
To
Total no. of weeks due (incl. any public hols. due)
Day
Mth
Year
Day
Mth
Year
Weekly amount of Social Welfare Benefit
€
Total amount of Social Welfare Benefit payable during the period
€
Weekly payment by Employer under Sick Pay Scheme
(Exclusive of Social Welfare payments)
€
Gross Weekly Pay
€
Total Arrears of Sick Pay Claimed
€
I apply for payment due to me under the Protection of Employees (Employers' Insolvency) Acts 1984-2003 and declare that I have made no other applications in respect of the amounts shown above. I am aware that my rights and remedies against my employer in respect of these amounts will be transferred to the Minister for Enterprise, Trade and Employment when payment has been made. I also declare in respect of the amounts claimed above that I have made no appeal in respect of these amounts and I am not aware, to the best of my knowledge, that these amounts are the subject of appeal by someone else.
Signature:___________________________________________
Date:________________________________
WARNING: LEGAL PROCEEDINGS MAY BE TAKEN AGAINST ANYONE MAKING A FALSE STATEMENT ON THIS FORM
PART 2
Form EIP4
Department of
Enterprise, Trade
and Employment
EMPLOYEE'S APPLICATION FOR PAYMENT(S) UNDER THE INSOLVENCY PAYMENTS SCHEME OF ENTITLEMENTS UNDER THE EMPLOYMENT EQUALITY ACT, 1998, UNFAIR DISMISSALS ACT, 1977 COURT AWARDS IN RESPECT OF UNFAIR OR WRONGFUL DISMISSAL, MATERNITY PROTECTION ACT, 1994, ADOPTIVE LEAVE ACT, 1995 PARENTAL LEAVE ACT, 1998, NATIONAL MINIMUM WAGE ACT, 2000 AND STATUTORY MINIMUM WAGES UNDER AN EMPLOYMENT REGULATION ORDER
An Roinn Fiontar, Trádála agus Fostaíochta
Department of Enterprise, Trade and Employment
Protection of Employees (Employers' Insolvency) Acts, 1984-2003
NOTE: PLEASE READ NOTES BELOW BEFORE COMPLETING THIS FORM
I, FRANK FAHEY, Minister of State at the Department of Enterprise, Trade and Employment in exercise of the powers conferred on me by
sections 6
and
16
of the
Protection of Employees (Employers' Insolvency) Act 1984
(No. 21 of 1984) and the Labour (Transfer of Departmental Administration and Ministerial Functions) Order, 1993 (
S.I. No. 18 of 1993
as adapted by the Enterprise and Employment (Alteration of Name of Department and Title of Minister) Order, 1997 (
S.I. No. 305 of 1997
) and the Enterprise, Trade and Employment (Delegation of Ministerial Functions) Order 2003 (
S.I. No. 156 of 2003
), hereby make the following regulations