| P11D Questionnaire for Year Ended 5th April 2009 |
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(i.e. Director or Employee)
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| 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. |
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| 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. |
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| Relocation Expenses |
| Has the cost of relocating an individual exceeded £8,000? |
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| 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 |
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a. Private Medical Insurance:
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b. Private or home telephone:
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c. Travel and subsistence:
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| d. Vans made available for private use |
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e. Entertaining:
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f. Round sum expense allowances:
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g. Private subscriptions (i.e. golf club, fitness club etc)
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h. Use of company assets (i.e. house, villa, Yacht, furniture etc). Where computer equipment was provided, identify the cost separately.
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i. House, flat or other living accommodation:
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j. Private or other household bills (i.e. newspapers, repairs, gardener, cleaner, nanny etc)
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| k. Any other benefit identified specifically: |
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| Appendix 1 |
| Company Cars |
(i.e. Vauxhall Cavalier GLI 5 door Automatic)
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(If known)
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(If known)
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Details of accessories fitted:
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a.
(i.e. factory-fitted accessories)
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b.
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Has employee contributed to the cost of the car:
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a.
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b.
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| Fuel |
Was Fuel provided for Private Use?
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If Yes, please provide the following information:
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a. Petrol or Diesel
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b. Engine size
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c. . Please state if individual made good the whole cost of private fuel.
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| Appendix 2 |
| Beneficial Loans |
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