Appendix 3– Forms to notify the University

Guidance on completing the forms

The forms on the following pages are for completion by University employees. (Your partner will need to co-signour form even if they are not our employee). You only need to complete one of the forms. (If both partners are employed by the University, you must each submit the relevant form):

ShPL1 - If you are the Mother / ShPL3 - If you are the Child’s Father or the Partner of the Mother
ShPL2 - If you are the Primary Adopter / ShPL4- If you are the Secondary Adopter
The legal notice covered by these forms is made up of three elements:
6
6.1
6.2
If you are the primary carer –
Notice 1.‘Maternity/Adoption Leave Curtailment Notice’ setting out when you propose to end your maternity/adoption leave (unless you have already returned to work)
In order to create an entitlement to Shared Parental Leave, you must give eight weeks’ notice to end your entitlement to maternity or adoption leave early, which will then enable both eligible parents to take advantage of theshared parental leave regime. If this notice is given after the birth/adoption, it is binding. However, if it is given before the birth, the mother is able to revoke the notice up to six weeks after the birth –in case an unplanned situation arises.
And, whether you are either the primary carer or the partner –
Notice 2. ‘Notice of Entitlement and Intention’ giving an initial, non-binding indication of each period of Shared Parental Leave that you are requesting;
You mustassert your intention to take Shared Parental Leave, and give an indication of the dates (in blocks of full weeks). The first date that you wish to take must be at least eight weeks after the date you submit this notification, and after the date you stop your maternity leave; and
Notice 3. ‘Period of Leave Notice’ setting out the start and end dates of each period of Shared Parental Leave that you are requesting.
You must formally book one or more periods of Shared Parental Leave, stating the start and end dates of each period (in blocks of full weeks). Leave can be requested as one continuous block (automatically accepted), or in discontinuousblocks with periods at work in between (requires University approval). It must end no later than one year after the birth. You can book more than one block of leave at the same time, as long as you notify us of any period at least eight weeks before it is due to start. Once a period of leave has been agreed, if you wish to amend the period you must send the University written notice to vary the leave (see 7.5 of the policy). To do this, please submit a newNotice 3. The new notice must be given at least eight weeks before both the original date to be varied and the new date. You may: vary start and end dates; vary the amount of leave; or ask for a single period of leave to become discontinuous or vice versa.
If you have already decided the pattern of Shared Parental Leave that you would like to take, you can provide more than one type of notice at the same time, for example, as a partner you could provide your ‘Notice of Entitlement and Intention’ and ‘Period of Leave Notice’ at the same time.

Thesenotice periods are the minimum required by law but the earlier you are able to inform us, the more time we will have to consider your request. This is particularly useful if you wish to take periods of discontinuous leave.

For the purposes of confirming entitlement the University retains the right, within 14 days of Notice 2, to request evidence of a birth/adoption. Any information obtained for this purpose will be treated in strict confidence in line with Data Protection requirements and will be destroyed once any eligibility has been confirmed.

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Shared Parental Leave/Pay Request Form ShPL1

To be completedwhere the MOTHER is our employee

Your Personal Details (MOTHER)
Name
Job Title
Faculty/Service / Line Manager/Team Leader
Expected week of birth / Actual date of birth (if known)
Expected or Actual Start Date of your Statutory Maternity Leave / Pay

You must submit all three legal notices below. You can submit them all at the same time, or submit them separately, as long as you sign the form in each case and give us the correct notice. (To vary an agreed booking after you submit Notice 3, please submit a new Notice 3.) If you intend to submit them separately you should keep a copy of this form for your own reference.

Notice 1. Maternity Leave Curtailment Notice (to end your Maternity Leave / Pay)
No. of weeks maternity leave/pay you will take: / Date you willstop your maternity leave/pay early:
Total ‘pot’ (in weeks) of Shared Parental Leave remaining for both parents[1] / weeks
Total ‘pot’ (in weeks) of Shared Parental Pay[2]remaining for both parents[3] / weeks
Notice 2. Indication of the Shared Parental Leave/Pay Dates that YOU intend to take
You are legally required to provide these dates, but they arenot binding until you submit Notice 3.
I intend to take Shared Parental Leave: / Yes / No / Date you intend to start your Shared Parental Leave:
Total weeks YOU intend to take / Total weeks your PARTNERintends to take
YOUR INDICATIVEShared Parental Leave Dates (From – To) / Total Weeks / YOUR INDICATIVEShared Parental Pay Dates(From – To) / Total Weeks

Do not provide dates that your partner intends to take. The total weeks taken by you and your partner must not exceed the total ‘pot’ of weeks youindicated in Notice 1. Please note that if you intend to take more than one period of leave (‘discontinuous leave’) this will be subject to University consent when you submit Notice 3.

Notice 3. Binding Request to Book (or Vary) Shared Parental Leave that YOU will take
EITHER I wish to formally book my leave / pay for the first time / Yes / No
OR I now wish to vary dates I have booked via a previous Notice 3: / Yes / No
FORMAL BOOKING REQUEST for YOUR Shared Parental Leave Dates (From – To) / Total Weeks / FORMAL BOOKING REQUEST forYOUR Shared Parental Pay2 Dates(From – To) / Total Weeks

Do not provide dates that your partner intends to take. The total weeks taken by you and your partner must not exceed the total ‘pot’ of weeks youindicated in Notice 1. Please note that if you requestmore than one period of leave (‘discontinuous leave’) this is subject to University consent.

MOTHER’s Declaration
I am an employee of the University of Sunderland and I declare that the information given is accurate. My partner (named below) and I will be sharing responsibility for the care of the child, and:
To claim Shared Parental Leave: / To claim Shared Parental Pay:
  • I have been continuously employed by the University for the last 26 weeks at the end of the 15th week before the child’s expected due date and will still be working for the same employer at the start of each leave period.
/
  • I have had/will have had average weekly earnings, for the 8 weeks up to and including the 15th week before the expected due date, no less than the Lower Earnings Limit for National Insurance Contributions.

Should my partner or I cease to be eligible we will both inform our respective employers.
Your Signature: / Your Signature:
Date: / Date:
PARTNER’s Details (To be completed by the Child’s Father/Mother’s Partner)
Name:
Address:
National Insurance Number:
Employer Name & Contact Details:
PARTNER’s Declaration (To be completed by the Child’s Father/Mother’s Partner)
I am the Father of the child / Mother’s Partner and I declare that the information given is accurate, and:
  • At the time of birth I have/will have shared responsibility for the care of the child
  • In the 66 weeks leading up to the baby’s expected due date I have worked for at least 26 weeks and earned an average of at least £30 a week in any 13 weeks.
  • I consent to the amount of Shared Parental Leave (and pay if applicable) that my partner wishes to take and confirm that Notices 2 and 3 have been completed accurately.
  • I consent to the University of Sunderland processingthe information about me on this form.

Signature of the Partner:
Date:

Please keep a copy of this form for your own records as you may need to refer to it in the future.

Shared Parental Leave/Pay Request Form ShPL2

To be completed where the PRIMARY ADOPTER is our employee

Your Personal Details (PRIMARY ADOPTER)
Name
Job Title
Faculty/Service / Line Manager/Team Leader
Expected week of placement / Actual date of placement (if known)
Expected or Actual Start Date of your Statutory Adoption Leave / Pay

You must submit all three legal notices below. You can submit them all at the same time, or submit them separately, as long as you sign the form in each case and give us the correct notice. (To vary an agreed booking after you submit Notice 3, please submit a new Notice 3.) If you intend to submit them separately you should keep a copy of this form for your own reference.

Notice 1. Adoption Leave Curtailment Notice (to end your Adoption Leave / Pay)
No. of weeks adoption leave/pay you will take: / Date you will stop your adoption leave/pay early:
Total ‘pot’ (in weeks) of Shared Parental Leave remaining for both parents[4] / weeks
Total ‘pot’ (in weeks) of Shared Parental Pay[5]remaining for both parents[6] / weeks
Notice 2. Indication of the Shared Parental Leave / Pay Dates that YOU intend to take
You are legally required to provide these dates, but they arenot binding until you submit Notice 3.
I intend to take Shared Parental Leave: / Yes / No / Date you intend to start your Shared Parental Leave:
Total weeks YOU intend to take / Total weeks your PARTNER intends to take
YOUR INDICATIVE Shared Parental Leave Dates (From – To) / Total Weeks / YOUR INDICATIVE Shared Parental Pay Dates(From – To) / Total Weeks

Do not provide dates that your partner intends to take. The total weeks taken by you and your partner must not exceed the total ‘pot’ of weeks you indicated in Notice 1. Please note that if you intend to take more than one period of leave (‘discontinuous leave’) this will be subject to University consent when you submit Notice 3.

Notice 3. Binding Request to Book (or Vary) Shared Parental Leave that YOU will take
EITHER I wish to formally book my leave / pay for the first time / Yes / No
OR I now wish to vary dates I have booked via a previous Notice 3: / Yes / No
FORMAL BOOKING REQUEST for YOUR Shared Parental Leave Dates (From – To) / Total Weeks / FORMAL BOOKING REQUEST for YOUR Shared Parental Pay2 Dates(From – To) / Total Weeks

Do not provide dates that your partner intends to take. The total weeks taken by you and your partner must not exceed the total ‘pot’ of weeks you indicated in Notice 1. Please note that if you request more than one period of leave (‘discontinuous leave’) this is subject to University consent.

PRIMARY ADOPTER’s Declaration
I am an employee of the University of Sunderland and I declare that the information given is accurate. My partner (named below) and I will be sharing responsibility for the care of the child, and:
To claim Shared Parental Leave: / To claim Shared Parental Pay:
  • I have been continuously employed by the University for the last 26 weeks at the end of the 15th week before the placement date and will still be working for the same employer at the start of each leave period.
/
  • I have had/will have had average weekly earnings, for the 8 weeks up to and including the 15th week before the placement date, no less than the Lower Earnings Limit for National Insurance Contributions.

Should my partner or I cease to be eligible we will both inform our respective employers.
Your Signature: / Your Signature:
Date: / Date:
PARTNER’s Details (To be completed by the Secondary Adopter)
Name:
Address:
National Insurance Number:
Employer Name & Contact Details:
PARTNER’s Declaration (To be completed by the Secondary Adopter)
I am the Father of the child / Primary adopter’s Partner and I declare that the information given is accurate, and:
  • At the time of the child’s placement I have/will have shared responsibility for the care of the child
  • In the 66 weeks leading up to the placement date I have worked for at least 26 weeks and earned an average of at least £30 a week in any 13 weeks.
  • I consent to the amount of Shared Parental Leave (and pay if applicable) that my partner wishes to take and confirm that Notices 2 and 3 have been completed accurately.
  • I consent to the University of Sunderland processing the information about me on this form.

Signature of the Partner:
Date:

Please keep a copy of this form for your own records as you may need to refer to it in the future.

Shared Parental Leave/Pay Request Form ShPL3

To be completedwhere the FATHER or MOTHER’s PARTNERis our employee

Your Personal Details (FATHER, or MOTHER’s PARTNER of either sex)
Name
Job Title
Faculty/Service / Line Manager/Team Leader
Details of the MOTHER’s Maternity Leave / Pay
Expected week of birth / Actual date of birth (if known)
Expected or Actual Start Date of Mother’s Statutory Maternity Leave / Pay
No. of weeks maternity leave/pay the Motherwill take: / Date the Mother will stop her maternity leave/pay early:
Total ‘pot’ (in weeks) of Shared Parental Leave remaining for both parents[7] / weeks
Total ‘pot’ (in weeks) of Shared Parental Pay[8]remaining for both parents[9] / weeks

You must submitbothlegal notices 2 and 3 below (Notice 1 only applies to your partner at their own employer). You can submit them at the same time, or submit them separately, as long as you sign the form in each case and give us the correct notice. (To vary an agreed booking after you submit Notice 3, please submit a new Notice 3.) If you intend to submit them separately you should keep a copy of this form for your own reference.

Notice 2. Indication of the Shared Parental Leave / Pay Dates that YOU intend to take
You are legally required to provide these dates, but they arenot binding until you submit Notice 3.
I intend to take Shared Parental Leave: / Yes / No / Date you intend to start your Shared Parental Leave:
Total weeks YOU intend to take / Total weeks the MOTHER intends to take
YOUR INDICATIVE Shared Parental Leave Dates (From – To) / Total Weeks / YOUR INDICATIVE Shared Parental Pay Dates(From – To) / Total Weeks

Do not provide dates that the mother intends to take. The total weeks taken by you and the mother must not exceed the total ‘pot’ of weeks you indicated in Notice 1. Please note that if you intend to take more than one period of leave (‘discontinuous leave’) this will be subject to University consent when you submit Notice 3.

Notice 3. Binding Request to Book (or Vary) Shared Parental Leave that YOU will take
EITHER I wish to formally book my leave / pay for the first time / Yes / No
OR I now wish to vary dates I have booked via a previous Notice 3: / Yes / No
FORMAL BOOKING REQUEST for YOUR Shared Parental Leave Dates (From – To) / Total Weeks / FORMAL BOOKING REQUEST for YOUR Shared Parental Pay2 Dates(From – To) / Total Weeks

Do not provide dates that the mother intends to take. The total weeks taken by you and the mother must not exceed the total ‘pot’ of weeks you indicated earlier in this form. Please note that if you request more than one period of leave (‘discontinuous leave’) this is subject to University consent.

FATHER or MOTHER’s PARTNER’s Declaration
I am an employee of the University of Sunderland and I declare that the information given is accurate. My partner (named below) and I will be sharing responsibility for the care of the child, and:
To claim Shared Parental Leave: / To claim Shared Parental Pay:
  • I have been continuously employed by the University for the last 26 weeks at the end of the 15th week before the child’s expected due date and will still be working for the same employer at the start of each leave period.
/
  • I have had/will have had average weekly earnings, for the 8 weeks up to and including the 15th week before the expected due date, no less than the Lower Earnings Limit for National Insurance Contributions.

Should my partner or I cease to be eligible we will both inform our respective employers.
Your Signature: / Your Signature:
Date: / Date:
MOTHER’s Details (To be completed by the Child’s Mother)
Name:
Address:
National Insurance Number:
Employer Name & Contact Details:
MOTHER’s Declaration (To be completed by the Child’s Mother)
I am the Child’s Mother and I declare that the information given is accurate, and:
  • At the time of birth I have/will have shared responsibility for the care of the child
  • In the 66 weeks leading up to the baby’s expected due date I have worked for at least 26 weeks and earned an average of at least £30 a week in any 13 weeks.
  • I have ended or given notice to my employer to end my maternity leave entitlement (including my entitlement to maternity adoption pay or maternity allowance if applicable).
  • I consent to the amount of Shared Parental Leave (and pay if applicable) that my partner wishes to take.
  • I consent to the University of Sunderland processing the information about me on this form.

Signature of the Mother:
Date:

Please keep a copy of this form for your own records as you may need to refer to it in the future.