Application for Payment Template
Application for payment template on FieldHive's own form for a payee's payment notice under the Construction Act: type the value of work to date, materials on site, retention and what has already been certified, and the amount due is calculated — with the date the notice must be given, the pay less notice deadline and the final date for payment worked out from the payment due date. Free, no sign-up. You apply; we supply the form.
1 Parties and contract
2 Application and dates
3 Valuation — cumulative value of work executed to the valuation date
4 Applied by
Export this application for payment
The A4 PDF is free to download now. Enter your email once to unlock the editable Word version and add your own logo.
- Editable Word template — reword it and reuse it
- Your own logo on the document (PDF & Word)
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Search 'application for payment template' and you get a guide from a payment platform, two Excel downloads, a Pinterest pin, an Etsy listing and three PDFs of other people's filled-in forms. All of them stop where the work starts: the four numbers that make the sum — the gross valuation to date, the materials on site, the retention and what has already been certified — and the dates the Construction Act hangs on them.
This form does that part. Type the items of work and their value to date, the materials on site and the retention rate, tell it what has been certified so far, and it produces the application with the amount due and the basis of calculation — the two things section 110A says a payee's notice must state — plus the timeline for the notice, the pay less notice and the final date for payment.
Value the work, set the dates, download
Parties, contract and dates
You, the payer, the sub-contract or order reference and the site. Then the application number, the valuation date and the payment due date from your contract — the notice date, pay less deadline and final date for payment fill in from it. The 17-day and 7-day periods are the Scheme for Construction Contracts defaults; change them to your contract's.
The valuation
One line per item of work with its contract value and its cumulative value to date; variations on their own lines. Add materials on site, choose the retention percentage and whether it applies to materials, and enter what has already been certified or paid. The amount due is calculated as you type. Under CIS, choose 0% (gross payment status), 20% or 30% and enter the materials in the application: the deduction is worked out on the labour element and the net payment expected is shown.
Sign and send
Your name and a signature on screen (or sign the print). Download the A4 PDF free; the editable Word version and your logo unlock with an email. The next application on the same contract carries this net valuation into 'previously certified' automatically.
A payee's notice, not an invoice — section 110A and the five-day window
The Housing Grants, Construction and Regeneration Act 1996 (as amended by the 2009 Act) makes every construction contract provide for payment notices. Where the contract puts the notice on the payee, it must be given no later than five days after the payment due date and must state the sum the payee considers due at that date and the basis on which it is calculated (s.110A). That is what this form is. If the payer disagrees, they must serve a pay less notice by the date the contract sets (s.111); if they serve nothing, the sum in the application becomes the notified sum and is payable in full by the final date for payment.
Where the contract does not comply, the Scheme for Construction Contracts fills the gaps: the final date for payment is 17 days from the due date and a pay less notice must be given at least 7 days before it. Those are the defaults in the form; your contract's periods override them. This page describes the mechanism; it is not legal advice.
Everything the five sections record
What the numbers do
Gross valuation
Work to date £42,000 plus materials on site £3,000 = £45,000.
Retention
At 5% on the gross: £2,250 held. Net valuation £42,750.
Previously certified
Applications 1–3 certified £31,000 in total. Amount due this application: £11,750.
Dates
Due date 30th → notice by the 5th of next month, pay less notice by the 10th, final date for payment the 17th (Scheme periods).
Sits with the payment-law guides, the invoice and the statement
An application for payment is one step in a chain: the sub-contract's payment terms, the application, the pay less notice if there is one, the invoice when the sum is agreed, and the chase if it is late. FieldHive has a guide for each step and a free document for the money end.
You apply. We supply the form.
This tool lays the application out and does the arithmetic on the figures you enter. It does not value the work, it does not know your contract's payment terms, and it does not decide whether retention or the reverse charge applies to you. The periods on the form are the Scheme defaults until you change them. None of this is legal advice — if a payment is disputed, read the contract and take advice.
The FieldHive app does not produce interim applications. This is a free standalone form. The PDF is free with no sign-up; the editable Word version and the logo upload unlock with an email.
Turn it into a connected job workflow
FieldHive keeps the enquiry, quote, job, invoice and payment connected — so it's built from the accepted quote instead of retyped, and the numbers carry through.
Other free tools for your trade
More FieldHive document tools — and the calculators behind the figures.
How to write a payment application
The guide behind this form — the notice mechanism, what to include and the timeline.
read the guide →Pay less notice
What the payer must do to pay less than the application, and by when.
the payer's side →CIS & VAT Invoice Generator
The invoice once the sum is agreed — reverse charge and CIS deduction handled.
invoice the certified sum →Statement of Account Generator
Every application, invoice and payment on one running statement with the balance due.
show the balance →Application for payment questions
Quick answers to the questions people ask most.
The application is one sheet in the job
An application for payment is the money side of a job you are already running. FieldHive keeps the enquiry, quote, job, invoice and payment connected for that customer — the interim application is the one thing it leaves to you.
