Curtailment Notice Formfor Shared Parental Leave (SPL)

Please complete this form if you wish to curtail your maternity / adoption leave and apply for Shared Parental Leave. You must submit this form at least 8 weeks before the first period of your SPL.

School Name:
Assignment (Employee) Number:
Full Name:

Please complete and sign Part A where you wish to take SPL, or where you and your partner both wish to take SPL. If you wish to curtail your maternity / adoption leave but only your partner will take SPL please complete and sign Part B.

Part A

I have read the guidance on Shared Parental Leave and I confirm:

  • I wish to bring my maternity/adoption leave to an end
  • I wish to bring my statutory / contractual maternity / adoption pay to an end (if entitled to receive maternity / adoption pay at the date you choose to end your maternity / adoption leave)
  • I have completed the Notice of entitlement and intention to take SPL form AND the declaration within that form that my partner has provided a notice of entitlement and intention to take SPL to their employer and that I consent to amount of leave that he/she intends to take.

At the date given below for ending my maternity / adoption leave, I confirm I will have:

  • Taken two weeks’ compulsory maternity leave after the birth, or two weeks’ adoption leave
  • Have at least one complete week of maternity / adoption leave remaining to me, in order that it can be taken as SPL.

The date given for ending my leave/pay is at least eight weeks from the date I have signed and posted or handed this form to my line manager / headteacher.

I wish to end my ordinary/additional maternity leave OR adoption leave on:
(Where applicable) I wish my statutory/contractual maternity OR adoption pay period to end on:
Signed (Employee): Date:

Part B

Please accept this as notification that I (the mother or main adopter) do not intend to take SPL (or ShPP where applicable) but that my partner does.

I have read the guidance on Shared Parental Leave and I confirm:

  • I wish to bring my maternity / adoption to an end
  • I wish to bring my statutory/contractual maternity/adoption pay to an end (if entitled to receive maternity/adoption pay at the date you choose to end your maternity/adoption leave)
  • I am either not entitled to SPL or do not intend to take SPL (or ShPP where relevant)
  • My partner has provided a notice of entitlement and intention to take SPL to his/her employer and that I consent to the amount of leave that he/she intends to take
  • I consent to my partner’s request to take SPL and/or ShPP

At the date given below for ending my maternity/adoption leave, I confirm I will have:

  • Taken two weeks’ compulsory maternity leave after the birth, or two weeks’ adoption leave
  • Have at least one complete week of maternity/adoption leave remaining to me, in order that it can be taken as SPL by my partner.

The date given for ending my leave/pay is at least eight weeks from the date I have signed and posted or handed this form to my line manager/headteacher.

I wish to end my ordinary/additional maternity leave OR adoption leave on:
(Where applicable) I wish my statutory/contractual maternity OR adoption pay period to end on:
Signed (Employee): Date:

Issued: July 2015