Shared Parental Leave (SPL) Form Adopters

Shared Parental Leave (SPL) Form – Adopters

This form should be completed by adopters employed by the University of Birmingham who intend to curtail their 52 weeks Adoption Leave for the purpose of themand/or their partner taking Shared Parental Leave (SPL). It incorporates:

• Notice of curtailment of Adoption Leave and pay
• Notice of entitlement to take SPL
• Notice of period of SPL

The form should be submitted to HR Service Portal8 weeks in advance of taking any SPL for it to be a valid notice. Further guidance on SPL is available at:

A. Notice of curtailment of adoption leave and pay

Please accept this as my notice to curtail my Adoption Leave and pay.

Name:

School or Budget Centre:

University Payroll number:

Child’s actual or expected date of placement:

Start date of Adoption Leave:

I confirm that I hereby give notice to curtail myadoption entitlements (leave and pay) with effect from the following date:

I understand that, if I am entitled to University Adoption Pay(UAP) and I curtail my Adoption Leave before UAP expires (18 weeks) to commence Shared Parental Leave, I will lose the entitlement to the remainder of my University Adoption Pay.I understand that I can only reinstate my Adoption Leave if I revoke this notice before the curtailment date given above.

Signature: Date:

Please see overleaf

If you intend to take SPL, please complete sections B and C overleaf. If you do not intend to take SPL, please complete the section below:

I confirm that:

• I do not intend to take SPL
• My partner has given notice to their employer to take SPL
• I consent to my partner’s intended claim for SPL andany SPL pay they may be entitled to

Signature: Date:

B.Notice of entitlement to take SPL

To be completed by both partners.

Please note: whilst a couple may jointly adopt a child, only one partner will be entitled to 52 weeks adoption leave, which can then be shared between both partners as SPL. For ease of reference, this person is referred to below as the ‘adopter’ (yourself) and their partner as the ‘partner’.

Adopter’s declaration

I confirm that:

• I am giving notice that I am entitled to and intend to take SPL and any SPL pay that I may be entitled to
• I had (or will have) the main responsibility for the care of the child at the time of the child’s placement, along with my partner who has made the declaration below
• I am entitled to Adoption Leave in respect to the child, my Adoption Leave period is reduced and the remaining weeks are now available as SPL
• I have, or will have, been continuously employed by the University of Birmingham for 26 weeks at the end of the week in which I was notified of having been matched for adoption
• I will remain employed with the University of Birmingham until each period of SPL that I intend to takebegins
• If I am claiming SPL pay, that I have been (or will be) earning above the Lower Earnings Limit in the 8 weeks leading up to the end of the week in which I was notified of having been matched for adoption with the child
• I intend to care for my child in the weeks I am on SPL
• I will inform the University immediately if I am no longer responsible for the care of the child
• If at any time I cease to be eligible for SPL or SPL pay, I will notify the University without delay
• The information provided in this declaration is accurate

Signature: Date:

Please see overleaf

Partner’s declaration

Partner’s name:

Partner’s employer’s name and address:

Partner’s payroll number if UoB employee:

Partner’s National Insurance number if not a UoB employee:

I confirm that:

• I am the adopter’s spouse, the adopter’s civil partner, or the adopter’s partner living with them and the child in an enduring relationship
• I had (or will have) the main responsibility for the care of the child at the time of the child’s placement, along with the child’s adopter
• I have been (or will have been) employed or self-employed in England, Scotland or Wales in 26 weeks of the 66 weeks preceding the week in which the adopter was notified of having been matched for adoption with the child
• I have (or will have) earned in total at least £390 in 13 weeks of the 66 weeks preceding the week in which the adopter was notified of having been matched for adoption with the child
• I consent to the amount of SPL that the adopter intends to take, as set out in section C
• I consent to the amount of SPL pay that the adopterintends to claim, as set out in section C
• I consent to the University of Birmingham processing the information I have provided

• The information provided in this declaration is accurate

Signature: Date:

Please ensure that section C is completed overleaf, detailing the period(s) of SPL leave that the adopter and/or partner intend to take.

C. Notice of a period of SPL

• You must submit this form 8 weeks in advance of the start of any period of SPL

• SPL is taken in week blocks (not individual days)
• If you (UoB employee) intend to take more than one period of SPL (discontinuous SPL), you need your line manager to approve the arrangement and must provide their written approval alongside this form. You can request up to 3 periods of discontinuous leave.

SPL entitlement

Total number of weeks AdoptionLeave taken/to be taken
(at least 2 of 52 weeks):

Total number of weeks SPL already taken by either partner

to date:

Total number of weeks SPL available (52 weeks, less weeks

of Adoption Leave and less weeks of SPL already taken):

SPL pay entitlement

Total number of weeks paid AdoptionLeave taken/to be

taken (UAP and statutoryadoption pay, at least 2 of 39
weeks):

Total number of weeks paid SPL taken by either partner

to date:

Total number of weeks paid SPL available (39 weeks, less

weeks of paid AdoptionLeave and less weeks of paid SPL

already taken):

I (the adopter) intend to take SPL on the following dates (if applicable):

Adopter’s total number ofweeks SPL:

Adopter’s total number of weeks paid SPL: Please see overleaf

My partner intends to take SPL on the following dates (if applicable):

Partner’s total number of weeks SPL:

Partner’s total number of weeks paid SPL:

Total number of weeks SPL (paid and unpaid) to be taken by adopter

and partner (not to exceed the SPL entitlement identified above):

Total number of the above week’s SPL taken by the adopter

and partnerthat will be paid (not to exceed the SPL pay entitlement

identified above):

Adopter’s signature

I confirm that I intend to take SPL on the dates detailed above and that, if I intend to take more than one period of SPL, I have provided written approval of the arrangements from my line manager. I understand that if I wish to change these dates I must give 8 weeks notice before the varied dates begin.

Signature: Date:

Partner’s signature

I confirm that I intend to take SPL on the dates detailed above:

Signature: Date:

Please return this form to:HR Service Portal

ForHR Office use:

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