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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 ________.
§ 2. Intended Period of Leave. I intend for my maternity leave to commence on ________ and to end on ________, covering a total of ________ days, inclusive of the additional fifteen (15) days with full pay to which I am entitled as a solo parent under Republic Act No. 8972, as amended. The estimated date of my delivery, as certified by my attending physician, is ________.
Xxxxx xx xxxxxxx xxx xxxx xxxxxxxxx xx xxxxxx xxx xxxxxxxx xxxx xx xxxxx xxxxxxx xxx xxxxxx xxxx xxxxxxxxxx xx xxx xxxxxxx xxxxx xxxx xx xxxxxxxx xxx xxxxx xxxxx xx xxxxxxx xxx xxxx xxxxxxxxx xx xxxxxx xxx xxxxxxxx xxxx xx xxxxx xxxxxxx xxx xxxxxx xxxx xxxxxxxxxx xx xxx xxxxxxx xxxxx xxxx xx xxxxxxxx xxx xxxxx xxxxx xx xxxxxxx xxx xxxx xxxxxxxxx xx xxxxxx xxx xxxxxxxx xxxx xx xxxxx xxxxxxx xxx xxxxxx xxxx xxxxxxxxxx xx xxx xxxxxxx xxxxx xxxx xx xxxxxxxx xxx.
§ 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.
§ 4. Allocation of Leave Credits. I do not intend to allocate any part of my maternity leave benefit to the child’s father or an alternate caregiver under Section 6 of Republic Act No. 11210.
§ 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 ________.
Xxxxx xx xxxxxxx xxx xxxx xxxxxxxxx xx xxxxxx xxx xxxxxxxx xxxx xx xxxxx xxxxxxx xxx xxxxxx xxxx xxxxxxxxxx xx xxx xxxxxxx xxxxx xxxx xx xxxxxxxx xxx xxxxx xxxxx xx xxxxxxx xxx xxxx xxxxxxxxx xx xxxxxx xxx xxxxxxxx xxxx xx xxxxx xxxxxxx xxx xxxxxx xxxx xxxxxxxxxx xx xxx xxxxxxx xxxxx xxxx xx xxxxxxxx xxx xxxxx xxxxx xx xxxxxxx xxx xxxx xxxxxxxxx xx xxxxxx xxx xxxxxxxx xxxx xx xxxxx xxxxxxx xxx xxxxxx xxxx xxxxxxxxxx xx xxx xxxxxxx xxxxx xxxx xx xxxxxxxx xxx.
§ 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: ________
§ 4. Allocation of Leave Credits. I hereby manifest my intention to allocate ________ days of my maternity leave benefit, which shall not exceed seven (7) days, to the child’s father, ________, as permitted under Section 6 of Republic Act No. 11210. The details of the allocation are set forth in the accompanying allocation form.
§ 4. Allocation of Leave Credits. I hereby manifest my intention to allocate ________ days of my maternity leave benefit, which shall not exceed seven (7) days, to ________, my ________, as alternate caregiver, as permitted under Section 6 of Republic Act No. 11210. The details of the allocation are set forth in the accompanying allocation form.
§ 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; (c) a copy of my Solo Parent Identification Card; and (d) such other documents as may be required, namely ________.
{"version": 1, "questions": [{"key": "solo_parent", "label": "Do you qualify as a solo parent?", "type": "text", "choices": [{"value": "no", "label": "No"}, {"value": "yes", "label": "Yes - the letter claims the additional fifteen (15) days with full pay and lists the Solo Parent ID as an attachment"}], "default": "no"}, {"key": "allocation_kind", "label": "Will you allocate part of your maternity leave to another person?", "type": "text", "choices": [{"value": "printed", "label": "Keep the printed wording and fill in the blank myself"}, {"value": "father", "label": "Yes, to the child's father"}, {"value": "caregiver", "label": "Yes, to an alternate caregiver - only if the child's father has died, is absent or is incapacitated (Section 6 of Republic Act No. 11210)"}, {"value": "none", "label": "No - the letter states that no days are allocated"}], "default": "printed"}, {"key": "receipt_block", "label": "Should the letter end with a \"Received by\" block for the employer?", "type": "text", "choices": [{"value": "yes", "label": "Yes - the employer signs and dates the copy on receipt"}, {"value": "no", "label": "No - omit the \"Received by\" block"}], "default": "yes"}], "labels": {"allocation_days": "Number of leave days allocated, in words and figures (up to seven, e.g. \"seven (7)\")", "allocation_recipient": "Full name of the person receiving the allocated days", "caregiver_relationship": "The caregiver's relationship to you (a relative within the fourth degree of consanguinity, or your current partner sharing the same household)", "allocation_intent": "Your intention (for example \"to\" or \"not\") - or choose an allocation option above"}, "help": {"allocation_kind": "Section 6 of Republic Act No. 11210 allows up to seven (7) days to be allocated. The details go in the accompanying allocation form.", "solo_parent": "If you choose \"Yes\", the total number of leave days you enter in § 2 should include the additional fifteen (15) days."}, "constraints": [], "dateRanges": [], "legacyReviewKeys": [], "scope": "A letter (Philippines) by which a female employee applies to her employer for maternity leave under Republic Act No. 11210 (105-Day Expanded Maternity Leave Law), stating the leave period, the SSS eligibility and the supporting documents. The form adapts the solo-parent leave, the allocation of leave days to the child's father or an alternate caregiver, and the acknowledgment-of-receipt block.", "notice": "A letter (Philippines) by which a female employee applies to her employer for maternity leave under Republic Act No. 11210 (105-Day Expanded Maternity Leave Law), stating the leave period, the SSS eligibility and the supporting documents. The form adapts the solo-parent leave, the allocation of leave days to the child's father or an alternate caregiver, and the acknowledgment-of-receipt block."}