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NOTIFICATION OF RESIGNATION DUE TO PREGNANCY
Please complete and return this form to Human Resources by the 15th week before the Expected Week of Childbirth (EWC). You may, if you wish, change the date of your resignation provided that at least 28 days notice is given of the revised date.
NAME:
JOB TITLE:
SCHOOL/SERVICE:
I wish to confirm that I will be terminating my employment with the University to have a baby on: / / . (Please attach a copy of your letter of resignation).
a) I confirm that I have notified my Head of School/Service that I am resigning from the University and the date of termination.
b) My expected week of childbirth is / /
c) I confirm that I will send to you my medical certificate (Mat B1 form) which will confirm my expected week of childbirth. Please ensure that your MAT B1 shows your name in the same format that you use for university payroll purposes.
d) I understand that, subject to my being eligible, I will receive Statutory Maternity Pay (SMP) through the University payroll for a period of 39 weeks commencing from the date following my termination date (or from the eleventh week before the expected week of childbirth if my termination date is earlier). Alternatively, if I am not entitled to SMP I may be entitled to Maternity Allowance (MA) which can be claimed through the Jobcentre Plus or Social Security Office.
e) I acknowledge that SMP will be paid through the University's payroll at the same intervals as I received my salary payment. I confirm that the following address should be used to send pay advices etc after I have left:-
Signed ....................................................... Date .....................................
FILENAME Form - Notify HR Resigning.dot
Last Updated: October 2006
PAGE 2
HUMAN RESOURCES
Corporate Services
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