Model Statement of Data for Payroll Taxes (Student Scheme)
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This form is intended for students and pupils who have a paid job alongside their studies or who receive an internship fee.
With this form you can:
- provide your data for payroll tax purposes
- indicate whether you want your employer to apply the payroll tax reduction (loonheffingskorting), or stop applying it
- indicate whether you want to use the student scheme (studenten- en scholierenregeling), or stop using it
Complete and submit
You can fill in the form on the computer. You need Adobe Reader 9.0 or higher. Once you have completed the form, you can print it and sign it.
Please submit the completed and signed form to your employer before your fist working day. If you are starting work on the same day your employer hired you, submit this statement before starting work.
Problems with completing the form?
It is best if you complete the form on a computer. We cannot guarantee a proper functioning on a tablet or smartphone.
If you are unable to complete the form on your computer, you should first save the form. You can do so by right-clicking on the link of the form and selecting 'Save target' (this term may differ per browser).