A.L.1 Form Schools

Adoption/ Shared Parental Leave
(Commencement/Return form)
A copy of this form must be completed to notify Payroll of the actual dates adoption leave and any periods of Shared Parental Leave (SPL) have commenced and ceased, to ensure correct payments to the employee.

A separate AL1 form must be completed for eachposition held. The following must be attached to the AL1 before the employee commences adoption leave:

  • The Adoption Matching Certificate(please ensure this is sent even if the employee does not qualify for SAP to enable an SAP1 form to be produced)
  • The 12 weeks half pay form if the employee has at least one years’ continuous service by the week in which they are notified of being matched with a child / children

If an employee wishes to take SPL a further AL1 form will need to be submitted on receipt of their curtailment notice form. The following must be attached to the AL1 form before the employee commences SPL:

  • Notice of Entitlement & Intention to take Shared Parental Leave form (or variation)
  • Period of Leave Notice form (or variation)

All Adoption& Shared Parental Leave paperwork can be found on the Essex Schools InfoLink, under Human Resources, Child Related Absences.

School Name
Assignment (employee) Number
Full Name

Part A (to be completed before the employee begins their adoption leave)

Start date of adoption leave /
Does the employee intend to return to work /

Yes/No

Is the employee currently receiving childcare vouchers
Please note deductions for childcare vouchers are stopped from pay once contractual pay has ended but you will need to carry on paying these as it is a legal obligation. /

Yes/No

Contractual Adoption Pay – 12 weeks half pay option

This part should only be completed for employees who have at least one years’ Local Government Service by the week in which they are notified of being matched with a child / children. Those on less than a years’ service are not entitled to Contractual Adoption Pay.

Please tick the option the employee has chosen –
The 12 weeks half contractual pay which would otherwise be paid to the employee after the first 6 weeks of adoption leave should be withheld.
And then paid to the employee in a lump sum with their first salary upon returning from adoption leave. /
The 12 weeks half contractual pay which would otherwise be paid to the employee after the first 6 weeks of adoption leave should be withheld.
And then paid to the employee after they have completed the equivalent of 3 months (for support staff) / 13 weeks (for teachers) normal duties from the date of the employees return to work. /
The 12 weeks half contractual pay should be paid to the employee whilst they are on adoption leave. /

School Authorisation

Signature /
Print Name
Tel. Number /

Date

Send completed and signed formto Payroll,County Hall, Market Road, Chelmsford, Essex CM1 1QH or

PAYROLL USE ONLY / Send Form EPF305 CRL to Essex Pension Fund
Signed (payroll): / Date sent:

Part B (to be completed following the end of the employees adoption leave)

If the employee is returning to work following adoption leaveplease enter their return date /
If the employee is not returning to work please enter their leaving date (do not make them a leaver on ePayroll) /
Is there any change to employee’s job/grade/hours/weeks
If Yes please complete ePayroll /

Yes / No

Term-time employees
Accrued holiday hours to be paid / Please state total number of hours to be paid
Part C (only to be completed if employee wishes to take Shared Parental Leave)
If the employee is curtailing their maternity leave for SPL purposes please state the date their maternity leave ends (mother only)
Please state below the periods of leave the employee wishes to take (from their period of leave notice)
Period / Start / End
Period 1
Period 2
Period 3
Is this a variation from a previous period of notice? / Yes/No
KIT and SPLIT Days (to be completed at the end of adoptiono / final period of SPL)
Are there any “Keeping in Touch” days to be paid / Yes/No
If Yes please state total number of hours to be paid / Are there any “Shared Parental Leave in Touch” days to be paid / Yes/No
If Yes please state total number of hours to be paid
Please arrange for Local Government Pension Scheme member to sign the section below if they wish to buy lost pension contributions

School Authorisation

Signature /
Print Name
Tel. Number /

Date

Send Send completed and signed form to Payroll,County Hall, Market Road, Chelmsford, Essex CM1 1QH or

PAYROLL USE ONLY / Send Form EPF305 CRL to Essex Pension Fund
Signed (payroll): / Date sent:
Part D – only applies to Local Government Pension Scheme (LGPS) members only
For the employee to complete upon return to work.
If you have taken any unpaid adoption leave or shared parental leave, you can choose whether or not you wish to pay for lost pension to cover this unpaid period away from work. If you would like to buy pension to cover this time, complete this section of the form and return it to your line manager. If you have more than one job, you will need to return one AL1 form for each job. If you send in the forms within 30 days of your return, your employer will pay two thirds of the cost of lost pension.
If you elect below to make up lost pension contributions, Payroll will calculate the lost pay figure (Assumed Pensionable Pay) and will write to you confirming the value. You will be instructed to use the online tool to calculate the amount to be paid and to complete the Additional Pension Contribution form. You will have the choice whether to pay monthly or as a lump sum. Please note that if you leave your employer before all the contributions have been deducted from your salary, your final pension could be reduced.
Yes I would like to make up the pension contributions lost during my period of unpaid maternity leave.
Signed……………………………………………………………………………….Date……………………………………
Part E – for Payroll team to action once the employee has returned to work
Assumed pensionable pay (APP) for unpaid maternity leave/SPL = £______
Employee notified of value to enter into Pensions online calculator.
Signed (for payroll): / Date:

July 2015