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Request Parental Leave Form

This form is a request for parental leave from an employee. It requires the employee to provide their name, department, employee ID, expected or actual birth/placement date of their child, and whether the child is entitled to disability benefits. The employee then selects the duration of their requested leave in weeks and the start date. The employee declaration confirms their parental status and responsibility for the child, who is under the age limit. The employee's manager must then sign to approve the leave dates before the form is submitted to payroll.

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chhoan_nhunlina
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© Attribution Non-Commercial (BY-NC)
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Download as PDF, TXT or read online on Scribd
21 views

Request Parental Leave Form

This form is a request for parental leave from an employee. It requires the employee to provide their name, department, employee ID, expected or actual birth/placement date of their child, and whether the child is entitled to disability benefits. The employee then selects the duration of their requested leave in weeks and the start date. The employee declaration confirms their parental status and responsibility for the child, who is under the age limit. The employee's manager must then sign to approve the leave dates before the form is submitted to payroll.

Uploaded by

chhoan_nhunlina
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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Request to take Parental Leave form

Your details and dates for leave Surname: First name(s): Department: Employee ID/payslip number: The baby is due to be born/placed on: .././. Or, if the child has been born/placed, the actual date of birth/placement: .././ The child is/is not* entitled to disability living allowance (*delete as appropriate) I want to be away from work for one/two/three/four* weeks (*delete as appropriate), for the week(s) commencing: OR I want to take parental leave on the following dates(see below):

Please note: only parents whose child is entitled to disability living allowance can take the leave in days or periods shorter than a week. Your declaration I declare that: I am named on the childs birth certificate, or I have, or expect to have, parental responsibility under the Children Act 1989 The child is below the age at which the right to parental leave ceases I will take time off work to care for the child or make arrangements for the childs welfare Signature: Date: Please forward this to your Head of Department/Section as soon as possible Agreement of Head of Department/Section Signature: Date: Please forward this to the Salaries Department

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