3 week old Wychwood Russian Blue baby kitten

3 week old Wychwood Russian Blue baby kitten

Self-Certification of Entitlement to Caternity Leave in respect of the adoption of a kitten

Section 1 – to be completed by the applicant (in block capitals)

Name: Employee Number:



Line Manager:

Your dates for pay and leave

The kitten is due to be adopted on:  

If the kitten has been born

please enter the actual date of birth: 

I would like my caternity leave and pay to start on:

I would like to be away from work for one / two weeks*

*Delete as appropriate

Your Declaration

You must be able to tick all three boxes below in order to qualify for caternity leave and pay.

I declare that:

I have or expect to have responsibility for the kitten’s upbringing

I will take time off to care for the kitten and support the co-adopter

I am one of the following:

  • The kitten’s legal adopter
  • Living in an enduring family relationship to the kitten’s legal adopter

Signed:      Date: 

A false declaration of eligibility for Caternity Leave may be viewed as Gross Misconduct and subject to action under the Disciplinary Procedure.

Section 2 – to be completed by the expectant co-adopter

Full Name: 

I nominate  (* insert name *)  as my primary provider of support at or around the time of my kitten’s adoption.



Please return this form to Human Resources and give a copy to your Manager

© Wychwood Russian Blue Cats 2016