AWR form

Statement 1
AWR Statement

In accordance with AWR we are required to request comparator information for any permanent member of staff that hold the same position as a temporary worker on this assignment. It is important that we gather this information to ensure that AWR is complied with.
Name of agency worker*
First Last
Is there a comparable perm worker to that of a temporary worker for comparison? (Doing the same or broadly similar work to the agency worker)?*
- Yes
- No
By ticking no you confirm that there are no comparable permanent staff to that of the temporary worker highlighted on this assignment. You therefore believe AWR does not apply in this instance.
Section 2
Day 1 rights

According to AWR agency workers are entitled to the same access to certain facilities and amenities as permanent employees performing the same role.

Please advice which of the following facilities the AWR agency worker will have access to.*

	Yes	No
Canteen or other similar facilities
Workplace nursery
Transport services (such as transport provided between sites)
Toilet and shower facilities
Staff common room
Waiting room
Mother and baby room
Prayer room
Food and drink machines
Car parking

If there are any other facilities the AWR agency worker will have access to, please include them here.
Will the temporary worker have the same access to information on vacancies as a comparable permanent worker?*
- Yes
- No
Week 12 rights

After an agency worker has completed a 12 week qualifying period with the same hirer in the same role, they will be entitled to the same basic terms and conditions of employment as if they have been employed directly.

Please now answer the following questions.
Rate of pay / salary?*
Hidden
Comparative rate of pay of permanent worker
Comparative bonuses or other relevant payments*
Working hours and days per week*
Night work?*
Annnual leave entitlement?*
Rest periods?*
Rest breaks?*
Paid time off for antenatel appointments?*
- Yes
- No
In addition, according to AWR, agency workers who have completed the 12 week qualifying period are entitled to paid time off for antenatal appointments.
For further information please visit: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/841981/agency-workers-regulations-2010-guidance.pdf
Submission
Please complete the following section with the details of the person that has completed this form.
Name*
First Last
Position in company*
Email*
Date completed*
Signature*
Phone
This field is for validation purposes and should be left unchanged.

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AWR form

Statement 1

AWR Statement

Section 2

Day 1 rights

Week 12 rights

Submission

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