NOT TO FILL IN – ONLY FOR BETTER UNDERSTANDING

NOT TO FILL IN – ONLY FOR BETTER UNDERSTANDING
VORDRUCK DES LANDESAMTES FÜR BESOLDUNG UND
VERSORGUNG BADEN- WÜRTTEMBERG
(Official form of Baden-Württemberg state office for saleries and pensions)
Payment of remuneration – declaration
Please note:
The following information is required to pay out your remuneration. Please see the attached data protection leaflet for
information on the legal provisions on the basis of which your data are collected. If the information is voluntary, this will
be marked in the form.
Until October 2013, we kindly ask you to always make sure to provide us with your account number, sort code, IBAN and
BIC.
1.
Please tick or fill in, as appropriate
Personal details
Name
First name
Personnel number/area of work
Name at birth if different
Date of birth
Telephone (voluntary)
Address (street, post code, place of residence)
Place of birth
Country of birth
Nationality
Sex
Academic degrees
Name of entity/office and place of work
Übersetzungshilfe zum LBV 42101 – 05/13
Marital status
Fill in this section only, if you are entitled to receive family-related benefits; otherwise the information is voluntary
□
□
□
□
□
single
married
registered civil partnership
divorced / marriage annulled or declared void
widower
IBAN, bank, BIC
Have you received a salary from Land Baden-Württemberg in the past?
□
□
no
Yes, under personnel no.:
Paying office:
2.
Tax details
My tax reference number is:
My tax code is:
Taxable band:
Note:
Income tax will be calculated temporarily on the basis of the tax code provided. The State Office will retrieve your tax
code electronically from the Central Tax Office using your tax reference number as soon as possible and calculate your
income tax retrospectively using this information.
Page 1 of 2
Kommentar [M1]: Please make sure to
also fill in LBV 42101s and LBV 42101z.
(Exception: research assistants, student
assistants, law clerks, working pensioners
do not have to fill in LBV 42101z)
3.
Details regarding family-related benefits
3.1
Applies only, if you are a legal clerk (Rechtsreferendar):
If your marital status is one of the following:
• married
• divorced and you have to pay maintenance
• single or divorced and you accommodate another person (e. g. a child) in your household and
you support this person
• widowed
you must
• fill in the declaration for the family allowance (form LBV 538b1).
Please attach appropriate proof of your marital status, e. g. marriage certificate, operative provisions of
the divorce decree including a note that it is binding and final, etc.
3.2
This applies only if you have one or more children, have been employed for more than six
months and wish to apply for child allowance for the first time or if you already receive child
allowance from a different family fund:
Please fill in the child allowance form (form LBV KG 1oed „Antrag auf Zahlung von Kindergeld an
Angehörige des öffentlichen Dienstes“ – application for payment of child allowance for public service
employees).
Declaration
I am aware that the details provided by me may influence the amount of my remuneration. I confirm that the above
information is both accurate and complete.
I am aware that I am obliged to immediately notify in writing any changes regarding this declaration to the Landesamt and
that I will have to repay any excess amounts that were paid due to inaccurate information or failure to notify changes.
I am also aware that claims arising from the employment will lapse, if I fail to assert them in writing within the exclusion
period of 6 months following such claims becoming due.
Übersetzungshilfe zum LBV 42101 – 05/13
Date, signature
Landesamt für Besoldung und
Versorgung Baden-Württemberg
70730 Fellbach
Page 2 of 2
THE ENGLISH TRANSLATION MERELY SERVES THE READER FOR A BETTER UNDERSTANDING;
ONLY THE GERMAN VERSION IS LEGALLY BINDING
VORDRUCK DES LANDESAMTES FÜR BESOLDUNG UND
VERSORGUNG BADEN- WÜRTTEMBERG
(Official form of the Baden-Württemberg state office for saleries and
pensions)
Data protection information leaflet
for employees and trainees
1. General
From the day you start work and/or your employment commences, we are responsible for determining and
paying out your remuneration and your child allowance and assistance*, if relevant. For this, we need your
personal data. We collect such data through forms which you receive either from us or from your human
resources department. Alternatively, you can download the forms from our internet pages at
www.lbv.bwl.de. To the extent that we collect data that we do not necessarily need to fulfil our tasks but
that facilitate our work significantly, for example your telephone number, we marked this in the form.
We use your data only to fulfil the tasks assigned to us by legislation and/or regulations by the state
government and the finance ministry regarding the areas of responsibility of Landesamt für Besoldung und
Versorgung Baden-Württemberg (LBVZuVO). We do not disclose or otherwise transmit your personal data,
unless we are obliged do so by law.
2. Legal provisions on the basis of which we collect your data
-
Section 13 Landesdatenschutzgesetz (LDSG) – state data protection act
Sections 36 LDSG, 113 (4) Landesbeamtengesetz (LBG) state civil servants act, and the relevant
administrative provisions (VwV-LBG)
section 28 o Fourth Social Security Code (SGB IV)
LBVZuVO and the relevant administrative provisions (VwV for LBVZuVO)
As a family fund we are responsible under section 72 subsection 1 income tax act Einkommensteuergesetz (EStG) for determining and making child allowance payments. We collect the
required data on the basis of the provisions of the income tax act pertaining to child allowance, in
particular section 62 et seqq. and section 68 EStG.
3. Processing and storage of your personal data
Your salary can only be calculated and paid out electronically.
Some of the incoming mail is collected electronically. To do this and to store your data we use a document
management system (DMS) and a calculation programme. To calculate your assistance* we use a special
secure programme.
The following personal data is stored:
-
Personal data (e. g. name, first name, title, date of birth, place of birth, sex, nationality, address)
Bank details
Marital status, personal data of the spouse and children, if relevant
Remuneration criteria (e. g. Remuneration bracket)
Details regarding a supplementary pension
Details regarding social security
Work department
Scope and duration of employment
Tax criteria (e. g. tax bracket, religious denomination, personal allowances)
Details regarding contributions to capital formation, if relevant
Details regarding salary foregone, if relevant
Basic data for assistance (e. g. insurance)*
Diagnostic data are not stored.*
THE ENGLISH TRANSLATION MERELY SERVES THE READER FOR A BETTER UNDERSTANDING;
ONLY THE GERMAN VERSION IS LEGALLY BINDING
4. Disclosure/transfer of data
To the extent that we are legally obliged to do this, we will disclose part of your data to the following agencies
that need the information to fulfil their tasks.
This includes in particular:
-
The tax administration
Social security carriers (e. g. the responsible health insurance provider, the German pension
insurance)
Agency to which capital forming contributions are paid over, if relevant
Agency to which salary foregone is paid over, if relevant
Relevant health insurance provider
German pension insurance
Versorgungsanstalt des Bundes und der Länder, VBL (Pension Institution of the Federal Republic
and the Länder, VBL), if relevant
Versorgungsverband bundes- und landesgeförderter Unternehmen e.V.,VBLU (Pension Association
of Companies supported by the Federal Republic and the Länder, VBLU), if relevant
Bayerische Versorgungskammer (Bavarian Pension Fund), if relevant
Pension scheme of a professional guild, if relevant
the responsible family fund, if relevant
the employer of the spouse (in case of employment in the public service or equivalent), if relevant
The information needed by your bank to transfer your salary will be disclosed to them.
Assistance data or documents will be disclosed to entities outside the assistance administration only in
exceptional cases and with your consent (e. g. health board, experts).*
* Note:
Only employees whose employment commenced prior to 01/10/1997 and whose employment has not been
interrupted since are entitled to receive assistance under a collective agreement.
THE ENGLISH TRANSLATION MERELY SERVES THE READER FOR A BETTER UNDERSTANDING;
ONLY THE GERMAN VERSION IS LEGALLY BINDING