The Maternity Leave Form For Employee is a legally required document under Irish employment law that must be completed when an employee wishes to take maternity leave. This form ensures compliance with the Maternity Protection Acts 1994 and 2004, capturing all necessary information including the expected date of confinement, intended leave dates, and benefit arrangements. It serves as an official record of the maternity leave request and subsequent approval, protecting both employer and employee interests. The form should be submitted at least 4 weeks before the intended start of maternity leave and includes sections for medical certification, leave dates calculation, and return-to-work intentions. It also facilitates the proper administration of both statutory and company-specific maternity benefits.
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1. Employee Details: Personal and employment information including name, employee ID, department, and start date of employment
2. Expected Date of Confinement: Due date as certified by medical practitioner
3. Intended Leave Dates: Proposed start and end dates of maternity leave, including the mandatory period
4. Maternity Benefit Declaration: Employee's intention regarding state maternity benefit application
5. Medical Certification: Details of medical certification confirming pregnancy and due date
6. Notice Period Confirmation: Confirmation that minimum notice periods are being observed (at least 4 weeks)
7. Return to Work Intention: Preliminary indication of intention to return to work after maternity leave
8. Employee Declaration: Employee's signed confirmation of information accuracy and understanding of entitlements
9. Employer Acknowledgment: Section for employer to acknowledge receipt and approve leave dates
1. Additional Leave Requests: Section for requesting additional unpaid maternity leave or other related leave types
2. Health and Safety Assessment: For roles requiring risk assessment during pregnancy
3. Ante-natal Care Arrangements: Section for recording planned ante-natal appointments and time-off requirements
4. Flexible Working Request: Optional section for requesting modified working arrangements before or after maternity leave
5. Company-Specific Benefits: Details of any additional company-specific maternity benefits or pay arrangements
1. Schedule 1 - Employee Rights Summary: Summary of maternity leave rights and entitlements under Irish law
2. Schedule 2 - Important Dates Calculator: Calendar tool/template for calculating key dates including latest notification dates, leave periods, and return dates
3. Schedule 3 - Contact Arrangements: Details of communication arrangements during maternity leave
4. Appendix A - Maternity Benefit Guide: Guide to applying for state maternity benefit
5. Appendix B - Company Policy Extract: Relevant excerpts from company maternity policy
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