SPL4A - Notification of Entitlement Form (Main Adopter)

Please use this online form to notify HR of your intention to take Shared Parental Leave as the main adopter.
I am writing to confirm that I am eligible for and that my partner and/or I intend to take a period of Shared Parental Leave (SPL).
 
I set out below the information that I am required to give to you to confirm my entitlement to SPL.
 
Name*
Email Address*
Payroll Number*
School/Department*
Date adoption leave started on:*
Date adoption leave ended on or will end on:*
My partner's full name*
The total amount of ShPP (in weeks) available to me and my partner is:*
My child's expected week of placement is*

If you are giving this notice before your child is placed, you will need to provide us with you child's placement date as soon as reasonably practicable before you take any leave.

My child's date of placement:
Name and address of Adoption Agency*
How much SPL and ShPP I intend to take (in weeks)*

This is to give us an initial indication of when you may want to take leave. It is not a formal request for SPL unless you let us know that you want us to treat this as a formal request.

Otherwise you will need to complete a request for SPL at least 8 weeks before each period of leave you wish to take.

How much SPL and ShPP my partner intends to take (in weeks)*
The start date of SPL I intend to take:*
The end date of SPL:*
The period(s) I intend to claim ShPP:*
In submitting this form I confirm that:
  • I satisfy the following eligibility criteria for SPL or will have satisfied them at the date I take leave.
  • I will remain in the employment until the week before my first period of SPL.
  • I have the main responsibility for the care of my child with the child's father/my partner.
  • I am entitled to statutory adoption leave and I have curtailed my period of adoptiom leave or have returned to work before the end of my adoption leave.
  • I have complied with the relevant notification requirement and provided any additional evidence as requested (as outlined within the relevant SPL Policy).
The information given in this notice is accurate.
 
I will inform you immediately if I cease to care for my child.
File Upload - Declaration from my partner providing the further information he/she is required to give*

Valid upload file types: .doc .docx .pdf
The file cannot be more than 10 MB in size

Line Manager's Approval

Line Manager's Name*
I can confirm that I have discussed this application with my line manager and he/she has agreed the dates stated above.*
Date of meeting:*
Additional Comments
Verification*