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Dependency Declaration Editor

Declare primary carer status for Additional Paternity Leave eligibility

👤 Employee Information

Optional - if applicable

🏢 Employer Information

👶 Child Information

? State your relationship: e.g., Father, Step-father, Partner of mother, etc.
When you plan to return from Additional Paternity Leave

👩 Mother/Partner Information

Optional - if known
? The name of the company or organization where the mother/partner works
? When the mother/partner expects to return to work after maternity/adoption leave

✅ Primary Carer Declaration

Important: To qualify for Additional Paternity Leave, you must confirm that you will have main responsibility for the care of the child. This is a legal requirement.
? The date you wish to begin Additional Paternity Leave. Must be at least 20 weeks after child's birth/placement.
? How long you intend to take Additional Paternity Leave for (maximum 26 weeks)
Based on start date and duration

📋 Statutory Confirmations

Eligibility Requirements: You must meet ALL of the following criteria to qualify for Additional Paternity Leave and Pay.

I confirm that:

✓ I am the biological father of the child or the mother's partner/spouse

✓ I will have main responsibility for the care of the child during the period of Additional Paternity Leave

✓ The child's mother/my partner has returned to work

✓ The child's mother/my partner has been entitled to Statutory Maternity Pay, Maternity Allowance, or Statutory Adoption Pay

✓ The child's mother/my partner has not returned to work before the end of her maternity/adoption leave period

✓ I have been continuously employed by the same employer for at least 26 weeks ending with the 15th week before the baby's expected week of birth or match date

✓ I have average weekly earnings of at least the Lower Earnings Limit for National Insurance contributions

✓ The information provided in this declaration is true and accurate to the best of my knowledge

📅 Declaration Date

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