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Maternity leave notification form template

Reviewed 30 September 2018

Used by the EMPLOYEE to notify the employer that they are pregnant and when they will commence Maternity Leave, giving options covering what Ordinary Maternity Leave (OML) and Additional Maternity Leave (AML) they will be taking, and whether they will be using any of their holiday entitlement at the beginning or end of the Maternity Leave period.

Maternity leave notification

Maternity Leave Notification

Please complete the relevant sections of this form and send a copy to your Line Manager and to HR Services no later than the end of the 15th week before your expected week of childbirth or as soon as is reasonably practicable. You should also send your MAT B1 form (issued by your GP after 26 weeks pregnancy) to HR Services. If you are unable to give the required notice, i.e. if the birth is earlier than expected, please complete this form as soon as practicably possible


Job title:


Employment start date:


I wish to take [weeks] weeks ordinary maternity eave (maximum available 26 weeks).

I wish my ordinary maternity leave to commence on [date].

(Please note - The start of the maternity lea

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