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      Contact details – business

      Name of business:
      Address:
      Email address *:
      Telephone number:

      Contact details – individual

      Title:
      First name(s):
      Surname:
      Date of birth:
      Email address:
      Telephone number:
      Position within business:

      Your Enquiry

      What is the name of the employee in question?
      Job title
      Date of commencement of his/her employment
      Date of termination of employment (unless continuing)
      Salary
      Gross £
      per
      Net £
      per
      Benefits (please list):
      Describe the nature of the dispute with the employee or action which may give rise to a dispute

      Existing employment tribunal proceedings

      Has the employee commenced any tribunal action in relation to the above?
      If so, on what date was the claim filed?
      What is the date by which your response is due (if not filed)?
      Describe the stage that the proceedings have reached (specify the final hearing date if you have been notified of one)