Letter Requesting Parental Leave - Template Form Pro · EN-CA-law

PRIVATE AND CONFIDENTIAL

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RE: Formal Request for Pregnancy/Parental Leave

Dear ________:

I am writing to provide formal written notice of my intention to take pregnancy and/or parental leave from my employment with ________ (the “Employer”), pursuant to the applicable employment standards legislation of the Province of ________ (the “Employment Standards Legislation”), and, where applicable, the leave provisions of my employment agreement and any governing collective agreement or workplace policy.

§ 1. Background

1.1   My current position with the Employer is ________, and my date of hire was ________.

1.2   The expected date of birth (or, where applicable, the date of placement, adoption, or arrival of the child into my care) is ________.

§ 2. Leave Requested

2.1   I hereby request the following leave: ________ (pregnancy leave, parental leave, or both, as applicable).

2.2   The total period of leave requested is ________, in accordance with my entitlement under the Employment Standards Legislation.

2.3   I would like my leave to begin on ________ and to end on ________, with my anticipated date of return to work being ________.

2.4   I understand that I am providing this notice within the minimum notice period required by the Employment Standards Legislation, and I will provide any further written notice required should the start date or duration of my leave change, subject to applicable statutory notice requirements.

§ 3. Statutory Entitlements and Continuation of Benefits

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3.3   I intend to apply for Employment Insurance maternity and/or parental benefits administered by Service Canada under the Employment Insurance Act (Canada). Please provide a Record of Employment in a timely manner and any supplemental unemployment benefit (top-up) information that may apply.

§ 4. Transition of Duties

4.1   I am committed to ensuring an orderly transition of my responsibilities. Prior to my absence, I will arrange for my duties to be properly delegated to co-workers or subordinates and I welcome the Employer’s direction on the most effective means of doing so.

4.2   Should any matters require my attention before my leave begins, I will do my best to address them in advance to ensure the transition is as seamless as possible for the Employer.

4.3   During my leave, I request that I not be contacted regarding work-related calls, emails, or other obligations, save for matters strictly necessary to administer my leave or benefits.

§ 5. Acknowledgement and Response Requested

5.1   Kindly confirm to me in writing that this request has been received and approved. If the Employer is unable to accommodate any part of this request, please set out in writing the reasons for doing so and propose dates on which we may meet to discuss the matter further.

5.2   If you require any additional information, documentation, or completed forms (including, where applicable, a medical certificate from a qualified health practitioner), please advise me and I will provide them promptly.

5.3   A copy of this letter is also being submitted to the appropriate department of the Employer for its records.

I appreciate your cooperation and look forward to working with you to ensure a smooth transition into my leave and, in due course, my return to work.

Yours sincerely,

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