NOTIFICATION OF INTENTION TO TAKE MATERNITY

LEAVE
Employees name
I confirm my baby is due week commencing
Form MATB1

is enclosed
will follow

The Company requires you to provide form MATB1.

This must be signed by your doctor or midwife no more than 20 weeks before the
baby is due.
If you fail to provide this form at least 28 days before you intend to start your
Maternity Leave, the Company will not be able to pay any SMP to which you may be
entitled.

I intend to start my maternity leave on

Date

You cannot start your maternity leave earlier than the 11th week before your expected
week of childbirth.
You must notify the company of your intended start date in the 15 th week before the
expected week of childbirth
If you wish to change this date you must give the Company at least 28 days notice of
when you want to start your maternity leave.
You can start your maternity leave on any day of the week
If you are absent from work for a pregnancy-related reason in the 4 weeks before
your expected week of childbirth, your maternity leave can be started automatically.
If you give birth before the date you intended to start maternity leave, your leave will
start on the day after the date of the birth.

I wish to return to work on

Date
You are not required to provide this information at this stage but it would be useful to
provide us with some indication for planning purposes
You may not return to work during the Compulsory Maternity Leave Period which is
the 2 week period after the birth
Ordinary Maternity Leave will end on the 26th week from when you start maternity
leave
Additional maternity leave is a further period of 26 weeks which begins on the day
following the last day of Ordinary Maternity Leave
SMP is payable for a total of 39 weeks : 6 weeks at 90% of pay and balance at
statutory rate
If you want to return to work before the end of your total maternity leave entitlement
you will require to give the Company 8 weeks notice.

Signed

________________________ Date

___________________ Form M1