Contributions payment

I confirm that the Local Government Pension Contributions below have been deducted as follows:

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Employer details

Name of person submitting this form *

Employer name *

Employer's contribution PJ050410001 *

Employees’ contribution PJ050410000 *

Total *

Monthly contributions Please select a month that this submission relates to

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Comments Please use the space below if you want to tell us why you are paying something in a certain way

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