Shared Parental Leave
February 2015
Form SPL 8A – Notice of Entitlement & Intention to Take Shared Parental Leave –Main Carer’s Partner /

Notice of Entitlement (and intention to take Shared Parental Leave)

To be given by the father/partner to her/his line manager and the manager to provide a copy to the HR Department, King’s Meadow Campus, Lenton Lane, Nottingham, NG7 7NR or email: .

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.

My Full Name:
My Partner’s Full Name:
My School/Department:
My Payroll Number:
The start and end dates of my partner’s adoption leave
The total amount of shared parentalleave (in weeks) available to me and my partner is:
The total amount of shared parental pay (in weeks) available to me and my partner is:
My child’s expected week of placement:
(if you are giving this notice before your child is placed you will need to provide us with your child’s placement date as soon as reasonably practicable and before you take any leave)
My child’s placement date:
Name and Address of Adoption Agency:
How much SPL and my ShPP I intend to take in weeks:
How much SPL and ShPP pay my partner intends to take (in weeks):
The start and end dates of each period of SPL I intend to take and in which period or periods I intend to claim ShPP:
(this is to give us initial indication of when you may want to take leave. It is not a formal request for SPL unless you tell us 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).
Any further applicable information:

In signing this form I confirm that:

  1. I satisfy the following eligibility criteria for SPL or will have satisfied them at the date I take leave:
  • I have main responsibility for the care of my child with the main adoptive carer.
  • I have complied with the relevant notification requirement and provided any additional evidence as requested (as outlined within the relevant SPL policy).
  1. The information given in this notice is accurate.
  1. I am the named child’s farther, or married to or the civil partner or partner of the named child’s main adopter.
  1. I will inform you immediately if I cease to care for my child or if my partner informs me that she/he has revoked her/his decision to curtail her period of adoption leave or pay.

I enclose a declaration from my partner providing the further information (s)he is required to give.

Signed: / Date:

For further information, advice or guidance, please contact your line manager, visit the HR web site at: email: or tel: 0115 951 5202.

Line Manager:

Date of Meeting: / Notes:
Confirmation of Agreement Y/N* / Details:
Signed: / Date:
Authorised By Head of School/Department Head / Signed: Date:

Office Use Only:

Received by Employment Support Services: / Signed: / Date:
Record Updated: / Signed: / Date:
Confirmation Letter issued / Signed: / Date:
Sent to Payroll / Signed: / Date:

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