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Maternity Leave Request - Template, Sample Form

✓ Designed for use in Philippines

Create your Maternity Leave Request for use in Philippines. Answer a few plain-English questions and the document fills in automatically as you go - then download it in Word and PDF, ready to sign or share.

  • Answer 24 simple questions - the document fills in as you go
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  • Download as Word (.docx) and PDF
  • Edit your answers and re-download anytime

How it works

  1. 1Answer a few simple questions
  2. 2Preview your document live
  3. 3Pay once - download in Word & PDF

Below you can preview the Maternity Leave Request, complete it by answering a few plain-English questions, and download a ready-to-sign copy in Word and PDF - tailored for use in Philippines.

What the Maternity Leave Request includes

This template is organised into the following sections:

Frequently asked questions

What is a Maternity Leave Request?

A Maternity Leave Request is a ready-to-use legal template for Philippines. You complete it by answering a few plain-English questions, then download the finished document in Word and PDF.

What does the Maternity Leave Request cover?

The Maternity Leave Request is organised into sections covering § 1. Employment Details, § 2. Intended Period of Leave, § 3. Statutory Entitlement, § 4. Allocation of Leave Credits, § 5. Eligibility for SSS Maternity Benefit, so the important points are captured in a clear, consistent structure.

What formats can I download?

You can download your completed Maternity Leave Request as an editable Microsoft Word (.docx) file and as a PDF.

Can I edit the document later?

Yes - save it to your account and you can re-open, edit and re-download it at any time.

Is a Maternity Leave Request legally binding?

Once it is properly completed and signed by everyone involved, a Maternity Leave Request is generally legally binding in Philippines, provided it meets the legal requirements that apply to this type of document.

What laws apply to a Maternity Leave Request in Philippines?

A Maternity Leave Request should comply with the laws in force in Philippines. This template is built around the provisions such situations commonly require, but the rules can vary by region and change over time, so check the current requirements for your case.

Do I need a lawyer to use a Maternity Leave Request?

For most standard situations you can complete the Maternity Leave Request yourself using the guided questionnaire. For high-value, unusual or high-risk matters, it is sensible to have a qualified lawyer review the finished document.

How do I sign the Maternity Leave Request?

Download the completed Maternity Leave Request as Word or PDF and sign it as required in Philippines. Depending on the document this may involve a handwritten or electronic signature, and some documents also need witnesses.

Is the Maternity Leave Request free?

You can preview the Maternity Leave Request and fill it in for free. A one-time fee applies only when you download the finished, ready-to-sign document in Word and PDF.

How long does it take to complete a Maternity Leave Request?

Most people finish the Maternity Leave Request in just a few minutes by answering the plain-English questions. You can save your progress and come back to it at any time.

Prepared and reviewed by the LegalDocs team.

Document preview

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Re: Application for Maternity Leave under Republic Act No. 11210

Dear ________:

I respectfully write to formally apply for maternity leave by reason of my pregnancy, in accordance with Republic Act No. 11210, otherwise known as the “105-Day Expanded Maternity Leave Law,” its Implementing Rules and Regulations, and the pertinent provisions of the Labor Code of the Philippines and Social Security Act of 2018 (Republic Act No. 11199).

§ 1. Employment Details. I am presently employed with ________ as ________, having commenced employment on ________, with employee identification number ________.

§ 2. Intended Period of Leave. I intend for my maternity leave to commence on ________ and to end on ________, covering a total of ________ days. The estimated date of my delivery, as certified by my attending physician, is ________.

§ 4. Allocation of Leave Credits. I hereby manifest my intention ________ to allocate up to seven (7) days of my maternity leave benefit to the child’s father or an alternate caregiver, as permitted under Section 6 of Republic Act No. 11210. The details of the allocation, if any, are set forth in the accompanying allocation form.

§ 5. Eligibility for SSS Maternity Benefit. I respectfully represent that I have complied with the qualifying conditions under Republic Act No. 11199, having remitted at least three (3) monthly contributions within the twelve (12)-month period immediately preceding the semester of my expected date of delivery, and that I have duly notified my employer and the Social Security System of my pregnancy in accordance with the prescribed rules.

§ 6. Supporting Documents. Attached herewith for your reference are the following: (a) a medical certificate issued by my attending physician indicating the fact and details of my pregnancy and the estimated date of delivery; (b) the duly accomplished SSS Maternity Notification; and (c) such other documents as may be required, namely ________.

§ 8. Contact and Return to Work. You may reach me at ________ or at ________. Should I be unreachable during my leave, I will be glad to attend to any matters requiring my attention upon my return to work, which I anticipate to be on or about ________.

I trust this application merits your favorable consideration. Thank you.

Very truly yours,



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Received by:


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Date Received: ________

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Fields you complete are inserted into the document live. This template is general guidance only - not legal advice.