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Shared Parental Leave Request

A completed Shared Parental Leave request with curtailment, continuous blocks, notice limits and SPLIT days.

Jurisdiction: England and Wales - completed fictional worked example

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Important: This sample provides general legal information only and is not legal advice. Check the law, prescribed forms and signing requirements that apply to your exact jurisdiction and circumstances before use.

# SHARED PARENTAL LEAVE REQUEST

Date: 29 August 2031

Parties: Nadia Patel and Greenwick Laboratories Limited

## 1. Purpose and parties

Nadia Patel requests Shared Parental Leave after her partner Alex Patel serves the required curtailment notice for maternity leave following their child's birth on 2 May 2031. Nadia confirms the family intends to use 18 weeks of the remaining statutory leave pool and that the eligibility declarations are supplied separately.

## 2. Facts, scope and terms

She requests a continuous block from 4 October to 31 October 2031 and a second continuous block from 1 January to 12 January 2032. Each block is at least one week; Greenwick must accept a properly made continuous notice if the statutory conditions and available pool are satisfied, while a discontinuous request would be subject to the employer's response options.

## 3. Process and responsibilities

Nadia gives the required notice and records the number of weeks of maternity leave and pay already used, the remaining SPL and Shared Parental Pay pool, and Alex's employer details. Greenwick may check the declarations but should not demand irrelevant family information.

## 4. Evidence, records and safeguards

Nadia asks to use two SPLIT days for a laboratory update and return-to-work planning, with dates and pay agreed in advance. SPLIT work is optional and does not silently convert leave into ordinary attendance; ordinary KIT arrangements are recorded separately if needed.

## 5. Review, escalation and outcome

Statutory Shared Parental Pay is payable for eligible weeks at the current rate or 90% of average weekly earnings if lower, subject to the remaining pay pool and any enhanced policy. Payroll will confirm tax and National Insurance treatment and explain any contractual top-up.

## 6. Reservations and practical protections

The request does not guarantee approval of a discontinuous pattern, and Nadia may withdraw a discontinuous notice within the statutory period if the employer declines it. She may appeal an administrative error and will not waive maternity, pregnancy, discrimination or family-leave rights.

## 7. England and Wales law and completion

England and Wales employment law applies. Nadia signs on 29 August 2031 and sends the request by hand and email as separate permitted methods. Greenwick will acknowledge receipt and confirm the accepted dates in writing.

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