Scribd
Upload
20 views2 pages

Paternity Leave Request Form

Jobin Franklin, an Areasupervisor, has submitted a paternity leave request form indicating his intention to take two weeks of paid leave starting on the expected date of his child's birth, June 10, 2024. He confirms that he is the child's biological father and will be responsible for the child's upbringing. The form is signed and dated August 21, 2024.

Uploaded by

aneeshaalphonse
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
20 views2 pages

Paternity Leave Request Form

Jobin Franklin, an Areasupervisor, has submitted a paternity leave request form indicating his intention to take two weeks of paid leave starting on the expected date of his child's birth, June 10, 2024. He confirms that he is the child's biological father and will be responsible for the child's upbringing. The form is signed and dated August 21, 2024.

Uploaded by

aneeshaalphonse
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

Paternity Leave Request Form

Name of employee: Jobin Franklin

Department: Areasupervisor

Expected week of
child's birth (the 39 weeks
Sunday at the
beginning of the Expected date: 06/10/ 2024
week in which the
child is expected to
be born):

Actual date of
child's birth (if
applicable):

I hereby give notice of my intention to take [one week's


Please tick as appropriate:
/two weeks'] paid ordinary paternity leave starting:

on the date on which the child is born OR

[ ] days after the child is born OR

on [ ] (a date later than the first day of the child's


expected week of birth) Yes

I declare that: Please tick as appropriate:

I am the child's biological father OR


Yes

I am married to the child's mother OR

I am the civil partner of the child's mother OR

I am the cohabiting partner of the child's mother

AND

I will have responsibility for the child's upbringing


Yes
AND

I will be absent from work for the purpose of caring for


the child or supporting the child's mother

Signed: Date:
Jobin 21/08/2024

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy