Notification of Shared Parental Leave (Mother Main Adopter)

RESTRICTED STAFF (When completed)

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Maternity, Paternity, Adoption & Shared Parentl Leave Policy CRxxxxxxxx

of 5 Notification of Shared Parental Leave CRxxxxxxxxxx v1.0

(When completed) RESTRICTED STAFF

xxxxxxxxxx Version 1.0

NOTIFICATION OF SHARED PARENTAL LEAVE FORM

Mother/ Main Adopter

PART ONE – To be completed by the employee

Employee Details

Full Name: Police No:

Area/Department: Rank/Grade:

Date:

Expected Due Date of child

Child’s actual birth/ placement date

Date Maternity/ Adoption leave started

Date SMP/SAP or MA started

HR CASE REFERENCE NUMBER:

I wish to cease my Maternity leave/ Adoption leave and pay on:

Shared Parental Leave

Please list dates you wish to take:

Last day of shared parental leave:

By ticking this box I confirm that I wish to end my maternity leave and maternity pay on and

start taking Shared Parental Leave

I wish to return to work on:


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PART TWO – To be completed by the employee

Sharing Parental Leave

Leave Currently taken

Date you have given notice to end your Maternity/Adoption leave and pay

Date SMP/SAP or maternity allowance ended

How many weeks of Maternity/Adoption leave did you take/ will you have taken at the point you begin/ began ShPL

Have you or your partner previously taken any weeks of ShPL with respect to this child?

How many weeks of SMP/SAP or MA were paid to you at the point you planned to begin ShPL

Have you or your partner previously taken any weeks of ShPP with respect to this child?

Planned Leave

How many weeks of ShPL do you intend to take?

How many weeks of ShPL does your partner intend to take?

How many weeks of ShPP do you intend to take?

How many weeks of ShPP does your partner intend to take?


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PART THREE – To be completed by the employee

Declarations

Mothers Declaration (BTP employee) Should the father be an employee rather than the mother please fill out the Notification of Shared Parental Leave Father/ Partner/ secondary adopter form.

I declare:

That the information I have given is correct

That I intend to care for the child during each week that I am on shared parental leave and/ or shared parental pay is paid to me

That I meet the duration of employment test Either

That I am, or will be entitled to SMP or Maternity Allowance (delete as applicable) Or I am not entitled to SMP or MA in respect of the birth of the child

That I have notified the end of the maternity pay or allowance period before the 38th week of first receiving it

That I will be absent from work in each week that ShPP is paid to me

That I am entitled to ShPL and I will be absent from work on ShPL for each week in which ShPP is paid to me or

That I have no entitlement to ShPL I confirm the information I have given is accurate

Signed: Date:

PLEASE FORWARD AUTHORISED COMPLETED FORM TO YOUR LINE MANAGER.

You will hear back within 14 days whether your application has been supported or not. You will also receive formal confirmation from the HRBC.


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PART FOUR – To be completed by the employee’s partner

Declarations

Father/ Partners/ secondary Adaptors Declaration

Full Name National Insurance Number

Home Address Employers name and Address

I declare:

I am the child’s father/ adopter’s husband/ adopter’s civil partner/ adopter’s partner living in an enduring relationship with the child’s adopter/ mother and the child.

I confirm that in the 66 weeks leading up to the (child’s EWC) I have worked for 26 weeks and I have worked as an employed or self employed earner in 13 of those weeks and have earned an average of £30 per week and paid national insurance contributions (or hold an exemption certificate for those weeks).

I confirm that I consent to the adopters/ mothers claim for shared parental pay

I confirm that I will immediately inform the adopter/ mother if I cease to have responsibility for the child or I discover I do not meet the employment and earnings test

I consent to the processing of the information I give by the adopters/ mother’s employer in connection with the payment of ShPP to the adopter/ mother

I confirm the information I have given is accurate.

Signed: Date:


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PART FIVE – Authorisation by line manager

I agree to the shared parental leave dates requested

I don’t agree to the shared parental leave dates requested due to: (please detail reasons below)

Date form has been rejected:

Signature: Date:

PLEASE FORWARD AUTHORISED COMPLETED FORM TO THE HR BUSINESS CENTRE AND DATES OF LEAVE SENT TO ROSTERING.

If form has been rejected, the form needs to be sent back to the employee within 14 days

explaining the reasons behind this decision.

ADMINISTRATION – To be completed by the HR Business Centre

Received By: Date:

Filed in personal file Date:

Entered on ORIGIN Date:

Payroll Informed Date:

Notification of Shared Parental Leave (Mother Main Adopter)

Documents

Transcript of Notification of Shared Parental Leave (Mother Main Adopter)