Adoption rights: Form for an employee to indicate that he or she has elected to receive statutory adoption pay and not statutory paternity pay (adoption within the UK) (form)

When to use this model adoption leave form

Use this model form to provide an employee with the means of declaring that he or she has chosen to receive statutory adoption pay and not statutory paternity pay (adoption) in relation to an adopted child.

Form wording

Name:

[ ]

Department:

[ ]

I previously notified you that I wish to take adoption leave commencing on [date].