FOR SAMPLE PURPOSES ONLY
In Confidence
Post Office Ltd
APPLICATION FOR APPOINTMENT AS SUBPOSTMASTER
* The expression “Subpostmaster” includes “Subpostmistress” throughout.
For Post Office® Use
Only Ref. No:
Details of the office(s) you are applying for. Please complete in
BLOCK CAPITALS
Name Address
Postcode
Please complete in BLOCK CAPITALS 1. Name Surname(or family name): Title (Mr/Mrs/Miss/Ms or other) Forenames (in full) Previous names (if applicable) e.g. name at birth, other names you have been known as Permanent Address & Postcode (in full)
Personal Details Applicant
Personal Details Partner/Spouse
2.
Telephone number
Home: Business: If at this address for less than five years, please state previous address: 3. Your National Insurance number: Date of birth: Place of birth (Town/County): Country of birth:
4.
Applicant:
Have you any debts or mortgages of any kind? If so, please give particulars on a separate sheet of paper, stating the amounts owed and the method of repayment. YES NO
Have you ever been the subject of bankruptcy proceedings (i.e. declared bankrupt, or executed deed of assignment or made a composition with your creditors)? If YES, please give particulars and state whether discharge has been obtained. Revised January 2005
YES
NO
FOR SAMPLE PURPOSES ONLY
Personal Details (Continued) in BLOCK CAPITALS
5. Please give details of any convictions, including motoring (but not parking) offences. Convictions or findings treated as spent by virtue of the Rehabilitation of Offenders Act 1974 should not be included. If, therefore, the only conviction or finding against you or your spouse/partner is treated as spent, your answers to 5a-c should be “NO”. As the position of subpostmaster is one of trust, Post Office Ltd carries out checks to verify either that information provided in this section is accurate, or that information which has not been provided should have been provided. These checks include credit reference checks and criminal record checks both on the applicant and on the applicant’s spouse/partner. Have you or your spouse/partner at any time: (a) been convicted or found guilty of any offence by a Court or Court Martial, including an offence for which you were absolutely or conditionally discharged or placed on probation? (b) been bound over without conviction for any offence? (c) had a summons issued against you or any charge brought against you in respect of any offence which has not yet been disposed of? YES NO
YES
NO
YES
NO
If the answer is YES for questions 5a - 5c please give details: (continue on a separate sheet if necessary)
6.
Have you or your partner/spouse ever held an appointment as a subpostmaster or been employed by Royal Mail Group plc or its subsidiaries in any capacity? If so please provide full details below. Position held & work location e.g. Subpostmaster at Anytown P.O. Date of appointment Date of cessation Reason for leaving
Applicant:
Partner/Spouse:
7.
DISABILITY If you are currently disabled, or have been disabled, this will not prevent you being considered for the vacancy you are applying for provided that you are able to fulfil the requirements of the vacancy. If due to your disability you have any special requirements to enable you to attend an interview, please state fully what these are.
Revised January 2005
FOR SAMPLE PURPOSES ONLY
Business Proposals in BLOCK CAPITALS
8. Will you be operating the service at the current premises? If no, please give full details of the proposed alternative site (continue on a separate sheet if necessary).
9.
Is the location for the business, leasehold or freehold? If the premises are, or will be, leased or rented, what period of notice of termination of tenancy will you be subject to? Are there any restrictions, which prevent the use of the premises as a sub post office? Has any necessary planning permission or bye-law consent been obtained? Will you reside at the premises?
10.
Please state if you have acquired, or intend to acquire the private business of the outgoing Subpostmaster? If so, do you understand that the acquisition of the business does not entitle you to preferential consideration for Post Office Ltd business?
11.
If appointed, do you propose to follow any other occupation or engage in any other business on the premises in which the Post Office® branch is situated? If so, please give details (continue on a separate sheet if necessary). If you propose to engage in some other business who will be the owner (s) of that business?
12.
Are the proposed Post Office® branch premises, situated in or adjacent to “licensed” premises under your control? If so, state the nature of the licence held. If it is an “on” licence, a plan should be attached showing the relationship of the Post Office® branch premises to the “licensed” premises and should indicate clearly the proposed means of public access to the Post Office ® branch.
13.
Are the premises in which the Post Office® branch will be situated used for any of the following kinds of activity? If so, give full particulars. a. Business connected with a parcel delivery company or otherwise with the carriage of parcels. Activity such as a Building, Provident or Friendly Society or bill payment facility, which involves or could involve the receipt or deposit of money? Business connected with a licensed betting office?
b.
c.
Revised January 2005
FOR SAMPLE PURPOSES ONLY
Business Proposals (Continued)
14a Do you, or any business you have an interest in, have any involvement in financial service business or introduce to any firm or individual who engages in such activities? (Examples include operating as an Independent intermediary or Representative of a Life Office.) Are the premises you are offering in your application shared with any other firm, which engages in financial services? YES NO
14b
YES
NO
Employment History in BLOCK CAPITALS
15 . PLEASE GIVE DETAILS OF ALL YOUR EMPLOYMENT HISTORY DURING THE LAST FIVE YEARS, IN CHRONOLOGICAL ORDER, STARTING WITH YOUR CURRENT OR MOST RECENT EMPLOYMENT. INCLUDE SELF-EMPLOYMENT OR OCCUPATION AND ACCOUNT FOR ANY GAPS IN YOUR EMPLOYMENT HISTORY. CURRENT OR MOST RECENT EMPLOYMENT Employer’s name & address: (include postcode)
Job Title or Role: Dates of Employment From: Industry Sector: (Please tick the main business activity) Wholesale/Retail Trade Banking/Finance/Insurance Education Health & Social Work IT industry Post Office employee (Please complete Q6) To:
Self-employed YES
NO
Public sector - local and central government Armed Services Police Other community services Other (please specify) :
Full detail of responsibilities / main duties and reason for leaving:
We need to obtain a reference from your current employer; can we seek this now? Yes No We will seek a reference from your current employer if an offer is made to you, and any offer made will be subject to the reference being satisfactory.
Revised January 2005
FOR SAMPLE PURPOSES ONLY
Employment History (Continued) in BLOCK CAPITALS
15 PREVIOUS EMPLOYMENT (continue on a separate sheet if necessary) 1. Employer’s name and address: (include postcode) Job title/ role: Dates of employment From: To:
Full detail of responsibilities / main duties and reason for leaving:
2. Employer’s name and address: (include postcode) Job title / role: Dates of employment From: To:
Full detail of responsibilities / main duties and reason for leaving:
3. Employer’s name and address: (include postcode) Job title / role: Dates of employment From: To:
Full detail of responsibilities / main duties and reason for leaving:
EXPLANATION FOR GAPS IN EMPLOYMENT HISTORY, give full address of the establishment and possibly a contact name. Include details of any fulltime education attended.
PLEASE NOTE Post Office Ltd reserves the right to seek additional references in relation to your employment / educational history over the last five years if it feels it is necessary to do so. Revised January 2005
FOR SAMPLE PURPOSES ONLY
16.
in BLOCK CAPITALS Please give details of two responsible people whom we may approach for personal references. Personal referees must be well acquainted with you, have known you for a minimum of 2 years, and must not be related to you. They should preferably be someone of standing in the community, and must be people we can approach immediately for a reference. Name: Address: (in full including Postcode) Name: Address: (in full including Postcode)
Personal References
17.
If you are invited to interview, please list below any dates during the next 6-8 weeks when you would NOT be available.
18. Please tick the following to indicate where you heard about or saw the vacancy. Heard from someone who works for Post Office Ltd - as a subpostmaster - as an employee Advertisement in a Post Office® branch Post Office® branches for sale list Business (estate) agent Post Office Ltd Web-site Other (please specify) :
19.
DECLARATION I declare that I have answered all the questions truthfully and fully, and that I am not aware of any circumstances, which, if known to Post Office Ltd, might cause it to question my honesty and suitability for appointment as subpostmaster. I understand that if this declaration or any of the particulars furnished by me or my spouse/partner is or was known by me to have been false or incomplete, Post Office Ltd will be entitled to bring my contract to an end immediately. I agree to Post Office Ltd confirming my National Insurance number with the Contributions Agency. I understand and acknowledge that, for the purposes of pursuing my application, Post Office Ltd may carry out credit reference checks, criminal record checks and other security checks on me and my partner/spouse, which could involve approaching credit reference agencies for information about our credit history and/or the use of information which Royal Mail Group plc and its subsidiaries already holds on me and/or my partner/spouse. I/We hereby consent to Post Office Ltd carrying out such checks for these purposes and I/we understand that the processing of the data supplied on this form is governed by the Data Protection Act 1998 and will be held and used in order to process this application. Signature of applicant: Signature of applicant's partner/spouse: Date: Date:
Post Office and the Post Office symbol are registered trade marks of Post Office Ltd. Post Office Ltd registered in England number 2154540 Revised January 2005
FOR SAMPLE PURPOSES ONLY
Registered Office: 80-86 Old Street, London EC1V 9NN
The following Information should be included with your application. Interviews may not be granted to applicants who fail to provide all of the information needed. Please work through the list below, ticking each item. For transfers to family members, only the items at 1, 5, 6, and 11 (if applicable) are required.
TICK ITEMS TO ENCLOSE OFFICE USE
1 2
3
4
5
6 7
Completed application form and any continuation sheets A full CV Freehold - documentary evidence that you are negotiating the freehold to the premises of the office you are applying for - e.g. provisional memorandum of sale, a letter from your solicitor or the vendor’s solicitor. These must include details of vendor and buyer, the address of the property to be sold, nature of business, and agreed purchase price. Leasehold - documentary evidence that you are negotiating a lease of the premises of the office you are applying for- e.g. provisional agreement between yourself and the landlord or a letter from your solicitor or the vendor’s solicitor, to include landlord details, applicant details, period of lease, details of notice period, any restrictions / conditions, details of annual rent and on-going lease charges. You will also need to produce evidence of the agreed provisional sale of the business, by way of a provisional memorandum of sale, or a letter from your solicitor, the vendor’s solicitor, or business transfer agent. Letter of Intent (if no Business Transfer Agent involved). Agreement signed by both parties documenting the subpostmaster’s intention to sell to you and your intention to purchase from him the business, property/premises. A bank/building society reference concerning your financial standing, or the enclosed bank reference consent letter fully completed, (appendix 2). 2 recent passport sized photographs with your name and reference number printed on the back of each photograph. If intending to purchase existing premises and/or business Copies of the last three years business accounts If not purchasing the premises but buying the goodwill, a letter of intent signed by both parties, with details of the agreed purchase price of the goodwill. If intending to relocate the office into your existing business premises Copies of your last twelve months business accounts Details of how you intend to finance the venture Copy of evidence of funds available from your own resources (bank/building society books or statements, shares, Peps, Tessa) Copy of any loan offer including terms and conditions of offer 6 months personal bank statements Fully completed business plan (if applicable) Evidence of how the “introductory payment” (if applicable) will be financed. This payment to be made in full direct to Post Office Ltd, seven days prior to taking up the appointment).
8
9
10 11 12
Revised January 2005