Form 2A: Application for Shared Parental Leave – by Mother/Lead Adopter
You should complete this notice to confirm your entitlement to SPL and to give a non-binding indication of how much leave and pay you wish to take and when. You should read the University Shared Parental Leave Policy which provides more information about SPL and the terms used.
Once completed, please send the form by email/hard copy to your College/Support Group HR Team, who will acknowledge receipt and notify your line manager. Please keep a copy of this form for your own records.
Please ensure the form is received by your College/Support Group HR Team at least 8 weeks in advance of your first intended period of SPL. If you are unable to provide the required 8 weeks’ notice, for example, because your baby was born prematurely, you should contact your College/Support Group HR before submitting this application form.
If you had/will have less than 26 weeks’ service at the end of the 15th week before the expected week of childbirth, or the date of matching for adoption, you must seek help from your College/Support Group HR Team before completing this form.
PART A - GENERAL INFORMATION & DECLARATION OF ENTITLEMENT
Section 1: Mother/lead adopter personal informationEmployee Name:
Employee Number: / Date of Start:
National Insurance Number:
Employee Telephone Number:
Employee Personal Email:
School/Support Department:
Line Manager Name:
Line Manager Email:
Section 2: Father/Partner personal information
Name:
National Insurance Number:
Home Address:
Employer Name: / Date of Start:
Employer Address:
Section 3: Maternity/Adoption Leave and Pay Details:
(a) Child's expected week of birth/placement for adoption:
(b) Child's actual date of birth/placement for adoption:
(c) Start date of maternity/adoption leave:
(d) End date of maternity/adoption leave:
(e) Number of weeks maternity/adoption leave taken/ to be taken:
(i.e. number of weeks between dates in (c) and (d) above)
(f) Number of weeks SPL available:
(i.e. 52 minus (e) above)
(g) Number of weeks’ statutory maternity/ adoption pay (or allowance) to be received by mother/lead adopter during maternity/adoption leave:
(h) Number of statutory Shared Parental Pay (ShPP) weeks available:
(i.e. 39 minus (g) above)
Note: only complete (h) if you are entitled to statutory SPL/ShPP, i.e. had 26 weeks’ service at (i) the 15th week before your baby was due to be born, or (ii) on the date of matching for adoption
Section 4: Non-binding intimation of Shared Parental Leave Dates
I intend to take SPL on the following dates (see notes below): Please state the start and end date of each period of leave and the number of weeks to be taken in each period.
Notes:
i. SPL must be taken in whole weeks, but can start and end on any day of the week
ii. SPL must be taken before the first anniversary of the child’s birth/placement
iii. The total number of weeks cannot exceed the number available (as detailed in Section 3 (f))
You may book the above time off at the same time as you submit this notice of your intention and eligibility to take SPL. To do so, please complete Booking Notice 3A or 4A. If you have yet to finalise your plans, you can submit your Booking Notices at a later date, provided they are received at least 8 weeks in advance of the first period of requested leave. Form 3A should be used to book a single continuous period of leave and Form 4A to book multiple, discontinuous periods.
Please complete the declarations of entitlement overleaf
Section 5: Declaration of Entitlement by Mother/Lead Adopter*please delete as appropriate
I declare that:
☐ Apart from my partner, I have/will have* the main responsibility for the care of my child
☐ I have returned to work/given notice* to curtail my maternity/adoption leave and pay
☐ I will comply with the University’s SPL notification and evidence requirements.
☐ My partner meets the required employment and earnings tests.
☐ I will inform my line manager and my College/Support Group HR Team immediately if I or my partner cease to care for the child, or otherwise cease to satisfy the conditions for entitlement to SPL or ShPP.
☐ I understand that the University of Edinburgh may verify and share information with my partner’s employer and/or HMRC for the purposes of administering SPL and statutory ShPP (subject to Data Protection Requirements).
☐ The information in this application is accurate.
Signature ………………………………………………………Date…………………………….
Section 6: Declaration of Entitlement by Father/Partner – not employed by UoE
*please delete as appropriate
I declare that:
☐ Apart from my partner, I have/will have* the main responsibility for the care of my child
☐ I meet the statutory ‘employment and earnings tests’ for SPL
☐ I understand that the University of Edinburgh may verify and share information with my employer and/or HMRC for the purposes of administering SPL and statutory ShPP (subject to Data Protection Requirements).
☐ The information in this application is accurate.
Signature ……………………………………………………….Date…………………………….
Section 7: Declaration of Entitlement by Father/Partner – employed by UoE
*please delete as appropriate
Note: if you intend to take SPL you must also complete Form 2B and submit it to your College/Support Group HR Team at least 8 weeks in advance of your first intended period of SPL
I declare that:
☐ Apart from my partner, I have/will have* the main responsibility for the care of my child
☐ My partner has returned to work/given notice* to curtail their maternity/adoption leave and pay
☐ I will inform my line manager and my College/Support Group HR Team immediately if I or my partner cease to care for the child, or otherwise cease to satisfy the conditions for entitlement to SPL or ShPP.
☐ I understand that the University of Edinburgh may share information with HMRC for the purposes of administering SPL and statutory ShPP (subject to Data Protection Requirements).
☐ The information in this application is accurate.
Signature ……………………………………………………….Date…………………………….
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Last Updated December 2015