Shared Parental Leave - Our Tesco

---

Shared Parental Leave Form A: For the colleague taking maternity/adoption leave to complete Section 1 Complete section 1 if you want to bring your maternity/adoption leave (and pay) period to an end early. My manager

I would like to bring my maternity/adoption leave (and pay) period to an end after

weeks on

I understand that it’s not normally possible for me to cancel this notice once it has been given. TICK I HAVE COMPLETED THIS FORM AS I AM ENTITLED AND INTEND TO TAKE SHARED PARENTAL LEAVE AS DETAILED BELOW

I CONFIRM THAT MY PARTNER HAS GIVEN THEIR EMPLOYER NOTICE OF THEIR INTENTION TO TAKE SHARED PARENTAL LEAVE AND THAT I AGREE WITH THE AMOUNT OF SHARED PARENTAL LEAVE THAT MY PARTNER IS INTENDING TO TAKE

I DO NOT INTEND TO TAKE SHARED PARENTAL LEAVE

Section 2 Complete section 2 if you are entitled to and wish to take Shared Parental Leave I am writing to let you know that I am eligible for, and that my partner and/or I intend to take, a period of Shared Parental Leave. The information below confirms my entitlement to take Shared Parental Leave My name

My partners name

My maternity/ adoption leave started on:

/

/

My maternity/ adoption leave ended/will end on:

/

/

My child’s due date (the date on my MatB1):

/

/

My child’s date of birth/date of placement:

/

/

Number of weeks maternity/ adoption leave taken:

1

The total amount of Shared Parental Leave (in weeks) available to me and my partner is: 52 MINUS MATERNITY/ADOPTION LEAVE TAKEN

=

The total amount of Statutory Shared Parental Pay (in weeks) available to me and my partner is: 39 MINUS MATERNITY/ADOPTION PAY RECEIVED

=

I intend to take this many weeks’ Shared Parental Leave and Pay: My partner intends to take this many weeks’ Shared Parental Leave and Pay:

I confirm that: I satisfy the following eligibility criteria for Shared Parental Leave or I will have satisfied them by the time I take leave: TICK I HAD BEEN EMPLOYED FOR 26 WEEKS BY THE TIME I WAS 25 WEEKS’ PREGNANT / AT THE END OF THE WEEK THE ADOPTION AGENCY NOTIFIED ME OF A MATCHING DATE AND I WILL REMAIN WORKING FOR TESCO UNTIL MY FIRST PERIOD OF SHARED PARENTAL LEAVE I HAVE THE MAIN RESPONSIBILITY FOR THE CARE OF MY CHILD WITH THE CHILD’S DAD/MY PARTNER I HAVE REDUCED MY PERIOD OF MATERNITY/ADOPTION LEAVE OR HAVE RETURNED TO WORK BEFORE THE END OF MY MATERNITY/ADOPTION LEAVE MY NORMAL WEEKLY EARNINGS IN THE 8-WEEK PERIOD ENDING WITH THE 15TH WEEK BEFORE MY CHILD’S DUE/PLACEMENT DATE WERE NOT LESS THAN THE LOWER EARNINGS LIMIT (CURRENTLY £111 PER WEEK) I INTEND TO CARE FOR THE CHILD DURING EACH WEEK THAT I AM RECEIVING SHARED PARENTAL PAY I HAVE PROVIDED ANY ADDITIONAL EVIDENCE REQUESTED

The information given in this form is accurate and I will inform you immediately if I cease to care for my child or if I cease to be eligible to take Shared Parental Leave or claim Statutory Shared Parental Pay. I enclose Form C from my partner providing the further information required from them.

Section 3 Complete section 3 to notify Tesco of the specific periods of Shared Parental Leave you wish to take Leave notice

Additional details

THE START AND END DATES OF EACH PERIOD OF SHARED PARENTAL LEAVE I INTEND TO TAKE:

THE START AND END DATES OF WHEN I WOULD LIKE TO RECEIVE STATUTORY SHARED PARENTAL PAY:

START

START

END

END

SIGNATURE

DATE

/

/

2