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Form for employee to request paternity leave and pay (birth before 7 April 2024)

Author: Lynda Macdonald

When to use this model paternity leave form

Use this model form to give employees the means to request paternity leave and pay in respect of a birth child, where the expected week of childbirth is before 7 April 2024.

For a version of the forms reflecting reforms introduced by the Paternity Leave (Amendment) Regulations 2024, see our Form to provide notice of entitlement to paternity leave (birth after 6 April 2024) and Form to provide period of leave notice to take paternity leave (birth after 6 April 2024).