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Form to Request Paternity Leave and Pay in Respect of a Birth Child

Paternity Leave Request Form (Birth Child)


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

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 of the child's birth. The employee can choose to begin the leave on the date on which the child is born, on a date falling a specified number of days after the child's birth or on a predetermined date which falls after the first day of the child's expected week of birth.

In order to be eligible for paternity leave, the employee must be the father of the child or married to, or the civil partner or partner of, the child's mother. 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 child's mother. The employee must have at least 26 weeks' service, as at the end of the 15th week before the week in which the child is due to be born.

The employee must give notice of his (or her) intention to take paternity leave by the end of the 15th week before the expected week of birth, 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.

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

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