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:
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
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
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
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