Parental leave request template
This form is for employees to use to notify or update the details of any parental leave that they intend to take.
Background information
Employees (including some casual employees) with more than one year's continuous service are entitled to up to 12 months’ unpaid parental leave in relation to the birth or adoption of their child (or their spouse/partner’s child).
Casual employees are entitled to unpaid parental leave if they:
have been engaged on a regular and systematic basis for a sequence of periods of employment during a period of at least 12 months; and
but for the birth or placement of the child, or the taking of the leave, would have had a reasonable expectation of continuing employment with the Company on a regular and systematic basis.
Employees may make a written request for an extension of up to 12 months’ unpaid parental leave immediately following their initial parental leave period. The Company may refuse this request on reasonable business grounds. The total period of leave taken by the employee, plus the period of leave taken by their spouse/partner, must not exceed 24 months.
Paid Parental Leave
Paid parental leave is provided as per the Federal Governments’ Paid Parental Leave Program, and is to be taken concurrently with unpaid leave, and does not extend the total period of leave.
Notice and evidence
An employee wishing to take parental leave (paid or unpaid) must give the Company notice at least 10 weeks before the start of the leave (or if that is not practicable, as soon as practicable) specifying the intended start and end dates of the leave. At least four weeks before the intended start date, the employee must confirm the dates (or advise any changes to the dates).
Once an employee has given notice, the employee must provide evidence of the date of birth (or in the case of adoption leave the day of placement and that the child will be under 16 on the day of placement). Usually this would be a medical certificate, or a letter from the adoption agency.
An employee may extend the original leave period once by giving four weeks’ written notice, provided the extended period does not exceed a total of 52 weeks.
Pregnant employees who wish to continue working during the six weeks prior to the expected date of birth may be required to provide a medical certificate clarifying whether they are fit to continue work. In some circumstances, the employee may be eligible to be transferred to a “safe job”.
For more information about parental leave, contact one of our HR Consultants.
Important note:
The following template has been colour coded to help you complete it as follows:
Explanatory information is shown in blue italics and should be deleted once you have completed the agreement.
The information contained in this document is general in nature. You must not rely on the information in this document as an alternative to legal advice from an appropriately qualified professional. If you have any specific questions you should consult one of our HR Professionals.
Parental leave notification form
Employee details
(Employee completes this page and forwards to Manager / Supervisor at least 10 weeks prior unless it is not practical).)
First name:Surname:
Position:
Contact phone number:
This request relates to (Tick one only):
Maternity leave
Paternity leave
Adoption leave
Leave details
Start date of leave:End date of leave:
Total period of leave (weeks/days):
Do you intend to apply for Parental Leave Pay under the Australian Government Paid Parental Leave scheme?
Yes
No
Unsure
Signature of employee:______Date:______/______/ ______
Confirmation or change of leave details
(This section is to be filled in by the employee and provided to the Manager / Supervisor at least 4 weeks before starting leave unless it is not practicable to do so).Start date:
End date:
Total period of leave (weeks/days):
Signature of employee:______Date:______/______/ ______
Acknowledgement of parental leave (to be completed by manager/supervisor)
Name of manager/supervisor:Signature of manager/supervisor:______Date:______/______/ ______