Notification of Paternity Leave form - Our Tesco

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Notification of Paternity Leave form

Name:

I would like to start my paternity leave on:

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The expected due/ placement date is:

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I want to take

week/s paternity leave

I want to take

days holiday directly before my paternity leave

My paternity leave is linked to my partner’s

TICK

MATERNITY LEAVE

ADOPTION LEAVE

I declare that:

TICK

I AM THE CHILD’S BIOLOGICAL FATHER OR I AM MARRIED TO OR IN A CIVIL PARTNERSHIP WITH THE MOTHER/ADOPTER OR I AM LIVING WITH THE MOTHER/ADOPTER IN AN ENDURING FAMILY RELATIONSHIP, BUT I AM NOT AN IMMEDIATE RELATIVE I HAVE RESPONSIBILITY FOR THE CHILD’S UPBRINGING.

I WILL TAKE TIME OFF WORK TO SUPPORT THE MOTHER/ADOPTER OR CARE FOR THE CHILD

SIGNATURE

Date:

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