Statutory Sick Pay (SSP)
About this form
This form is for employers to use to record details of their
For more information see the E14 Employer Helpbook
employee's Statutory Sick Pay (SSP). You must keep these details.
for Statutory Sick Pay which is available on the HMRC Basic
Keeping an accurate record of each absence will help make sure
you pay the correct amount of Statutory Sick Pay (SSP) for the
If you need help with this form or with the SSP scheme,
you can phone the Employer Helpline on 08457 143 143.
You do not have to use this form, but you may find it helpful.
You must keep SSP records for at least three years after the end
of the tax year to which they relate.
You are required by law to keep:
• records of dates of sickness lasting at least four days in a row,
that is Periods of Incapacity for Work (PIW), reported
by your employees, and
• records of all payments of SSP you make during PIW.
How to use this SSP record sheet
Box 1 Tick the qualifying days, and write in the date of
• read these guidance notes, and
• complete the Employee details below.
Box 2 Write in the maximum liability. Remember that
Boxes A to D – Information brought forward
you have to pay 28 weeks in a PIW. But if linked
For existing employee’s take the information you hold from
PIWs with you run longer than three years, your
the previous year’s record.
Surname or family name
National Insurance number
Information brought forward
First day of PIW
Date SSP1 form
Last day of PIW
Tick the qualifying days
Sun Mon Tue Wed Thu