ERRM Assessment Form

We will use this information to help us identify the issues quickly. It will save time when we talk to you about the case. Please answer as many questions as you can. If you don’t have a precise answer, an estimate will do. You will have a chance to expand on your answers when we talk to you

PS: THIS FORM IS FOR REFUGEES AND MIGRANTs.
Some of the questions might not apply to you, please answer the ones that apply to you.

The information you are about to provide is for ERRM only. We would not share this with anyone unless you ask us to help your case

Your Personal Details:

Full Name(Required)

Home Address(Required)

Post Code(Required)

Email Address(Required)

Phone Number(Required)

Whatsapp Number (optional)(Required)

Your Employer’s Details:

Name of the Employer(Required)

Office Address(Required)

Post Code(Required)

Email Address(Required)

Phone Number(Required)

Is your employer an agency?(Required)

If yes, where are you sent to work? Please enter name of company and address(Required)

How big is your employer? Roughly, how many employees?(Required)

Work Details:

Job Title / Type of work(Required)

Start Date

Select Employment Type:(Required)

How many days / hours did you work last week?(Required)

How many days / hours did you work last month?(Required)

Are you still in work or as your empllyment ended.. If ended, when?(Required)

Pay:

Were you paid hourly, weekly, daily or monthly?(Required)

What was the rate you were paid?(Required)

How much were you supposed to be paid?(Required)

What is the shortfall for each period(Required)

How much are you owed in total?(Required)

If you can, explain how you got to the estimated amount you are owed(Required)

Records and Documents:

Dont worry if you are not able to provide the requested documents here. The more you have is better

Did you get payslips, have you kept them? Have you kept them?(Required)

Are they on paper or are they on your phones/emails?(Required)

Do you have any time sheets or work rota? If you don’t, take your phone to work and take a photo it(Required)

Do you have a written contract? Do you still have a copy?(Required)

Do you have a letter of appointment?(Required)

Holiday:

Have you had any paid holidays since you started?(Required)

Have you had your full entitlement to your holidays?(Required)

Other Information:

Have you asked your employer about any of these issues?(Required)

What was the outcome?(Required)

Is there any other thing you’d like to share?(Required)

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