Welcome to Simply-Docs

Form to Request Paternity Leave and Pay in Respect of a Child Adopted From Within the UK

Paternity Leave Request Form (Adopted Child)


This form should be used in order to give employees the means to request paternity leave and pay in respect of a child adopted from within the UK.

Employees are entitled to take one week’s or two weeks' paternity leave in a single block within the period of 56 days beginning with the date on which the child is placed with the adopter. The employee can choose to begin the leave on the date on which the child is placed with the adopter, on a date falling a specified number of days after the child is placed with the adopter or on a predetermined date which falls after the child is expected to be placed with the adopter.

In order to be eligible for paternity leave, the employee must be married to, or the civil partner or partner of, the child's adopter (or one of a couple jointly adopting a child). The employee must expect to have responsibility for the upbringing of the child and be taking the leave to care for the child or support the adopter. The employee must have at least 26 weeks' service, as at the end of the week in which the child's adopter is notified of the adoptive match.

The employee must give notice of his or her intention to take paternity leave no more than seven days after the date on which the adopter is notified of the match, unless this is not reasonably practicable. In those circumstances, the employee should give notice as soon as reasonably practicable.

In order to be entitled to statutory paternity pay, the employee must have average weekly earnings of at least the lower earnings limit for National Insurance purposes. Additionally, the employee must confirm that he or she has chosen to receive statutory paternity pay and not statutory adoption pay in respect of the child.

This document is in open format. Either enter the requisite details in the highlighted fields or adjust the wording to suit your purposes.

Once you have subscribed to the appropriate document folder click on the “Download Document” button below. You will be asked what you want to do with the file. It is recommended that you save the document to a location of your choice prior to viewing.

Simply-4-Business Ltd Registered in England and Wales No. 4868909 Unit 100, Parkway House, Sheen Lane, London SW14 8LS

Simply-Docs uses cookies to ensure that you get the best experience on our website. Learn more