| Source: XpertHR P&D |
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Date: 05/10/2008 |
Publisher: XpertHR |
Maternity rights: Form for notification of an employee's intention to take maternity leave (form)
TOPICS:| terms, conditions and employee rights | working time and leave
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AUTHOR: Lynda Macdonald and Claire Birkinshaw
Form wording:
| Name of employee |
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| Job title |
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| Date of commencement of employment |
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| I wish to inform you that I am pregnant and I intend to take maternity leave as follows: |
| My last day of work will be on |
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| I will start my maternity leave on |
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| My expected date of childbirth is |
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| I enclose herewith my MAT B1/medical certificate issued by my doctor/midwife/recognised medical practitioner confirming the date my baby is due. |
I intend to return to work after my maternity leave.*
I do not intend to return to work after my maternity leave and I therefore confirm that I wish to resign from my employment with the Company and leave on the last day prior to the commencement of my maternity leave.*
(*delete as appropriate) |
| Signed |
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| Dated |
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To qualify for maternity leave, you must return this form to [name] by no later than the end of the 15th week prior to your expected week of childbirth. | |
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