Form 4A: Booking Notice for Discontinuous Periods of Shared Parental Leave –
Requested by Mother/Lead Adopter
You should use this form to request multiple blocks of leave, punctuated by periods of work (e.g. 4 weeks
SPL, 4 weeks’ at work, 4 weeks’ SPL). As outlined in the University Shared Parental Leave Policy, such a
pattern of leave is required to be considered and authorised by your line manager, and could be refused.
Alternatively, if you have sufficient notices remaining, you could use separate continuous leave booking
notices (Form 3A) for each of the separate blocks of leave.
You are entitled to serve up to three separate Booking Notices; Booking Notices can be withdrawn or
varied in accordance with the Shared Parental Leave Policy. If you withdraw or vary a notice, the original
notice may still count as one of your three notices.
You should read the University Shared Parental Leave Policy which provides more information about SPL
and the terms used.
Once completed, please send the form by email/hard copy to your College/Support Group HR Team, who
will acknowledge receipt and notify your line manager. Please keep a copy of this form for your own
records.
Section 1: UoE employee details:
Employee Name:
Employee Number:
Employee Start Date:
Employee Email:
Employee Tel. No:
School/Support Dept:
Line Manager Name:
Line Manager Email:
Section 2: Birth/placement details:
Expected date of birth/placement:
Actual date of birth/placement:
Section 3: Shared Parental Leave and Pay entitlement:
A. Total shared entitlement (weeks)
Leave
Statutory Pay**
52
39
B. Weeks already taken/booked by you or the person
you are sharing leave with:
C. Weeks remaining
(A minus B)
**inclusive of statutory pay for maternity/adoption leave and shared parental leave. Enter n/a in
‘statutory pay’ column if you do not qualify for statutory SPL/ShPP, i.e. will/did not have 26 weeks’
continuous service at the 15th week before the week in which your baby is/was due to be born or
on the date of matching for adoption.
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Section 4: I wish to take the following discontinuous periods of SPL:
(Complete if your child has already been born/placed or you know the exact dates on which you wish to take SPL)
Start date
Number of weeks’ SPL
End date
Total number of weeks:
Section 5: I wish to take the following discontinuous periods of SPL: (Complete if your child has yet to
be born and you wish to start your leave on a specified number of days after its birth/placement)
Start – number of days
after birth/placement
End – number of days
after birth/placement
Number of weeks SPL
Total number of weeks:
Section 6: I wish to receive statutory Shared Parental Pay (ShPP) as follows:
(please tick one box as appropriate)
 I do not qualify* for statutory ShPP (please go to Section 7 and 8)
 I do qualify* for statutory ShPP and wish to receive statutory ShPP for the weeks of SPL detailed
in sections 4/5 above
 I do qualify* for statutory ShPP and wish to receive statutory ShPP as follows:
*to qualify you must be entitled to SPL, i.e. have 26 weeks’ continuous service at the 15th week before your child
was due to be born, or the date of matching for adoption
SPL start date
SPL end date
Number weeks’ ShPP
Total number of weeks:
OR, if you wish to start your leave on a specified number of days after your child’s birth/ placement,
please specify the number of days after birth/placement
Start
Number weeks’ ShPP
End
Total number of weeks:
To claim enhanced shared parental leave, please complete Section 7 below.
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Section 7: University of Edinburgh Shared Parental Pay (UEShPP)
(Please tick one box as appropriate)
 I used all of my UE maternity/adoption pay during my maternity/adoption leave and understand I
have no entitlement to UEShPP
 I wish to take UEShPP as follows:
[Note, you must take any remaining UE maternity/adoption pay as UEShPP within 24 weeks’ of your child’s
birth/placement and in the same weeks as any statutory ShPP is payable]
Please confirm which option you selected during their maternity/adoption leave and how many weeks
remain to be taken as UEShPP (taking into account any SPL and UEShPP already taken/booked)
(tick one option only)
 Option 1: up to 16 weeks’ full pay; of which ………..weeks remain
 Option 2: 8 weeks’ full pay followed by up to 16 weeks’ half pay; of which………….weeks remain
 Option 3: statutory pay only; of which…………remain.

SPL start date
SPL end date Number weeks’
Pay option
( tick one box only)
UEShPP
 Full
 Part
 Statutory only
 Full
 Part
 Statutory only
 Full
 Part
 Statutory only
 Full
 Part
 Statutory only
Total number of weeks:
OR, if you wish to start your leave on a specified number of days after your child’ birth/placement, please
specify the number of days after birth/placement
Start
End
Number weeks’
UEShPP
Pay option
(tick one box only)




Full
Full
Full
Full








Part
Part
Part
Part
Statutory only
Statutory only
Statutory only
Statutory only
Total number of weeks:
Section 8: University of Edinburgh Shared Parental Pay (UEShPP)
Please complete this section if your partner is also employed by the University
(please tick one box as appropriate)
My partner is also employed by the University, and
 I do not intend to share any of my outstanding UE maternity/adoption pay with my partner as
UEShPP
 I intend to transfer all of my outstanding UE maternity/adoption pay to my partner for them to take
as UEShPP
(Note: if you
opted
receive statutory pay only,
this
willdate
not transfer to your partner;
you weeks’
will retain
the right to claim
SPL
starttodate
SPL
end
Number
UEShPP
back-dated UE maternity/adoption pay on your return to work for three months following your final period of SPL)
 I intend to share some of my outstanding UE maternity/adoption pay with my partner as UEShPP
Signed…………………………………………….. Date…………………………………………
Total number of weeks:
OR, if you wish to start your leave on a specified number of days after its birth/placement,
please specify the number of days after birth/placement
Start
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Number weeks’ UEShPP
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