Free Maternity Leave Application HR Template

MATERNITY LEAVE APPLICATION

To: Human Resources Department

[Your Company Name]

[Your Company Address]

Dear [HR Manager Name],

I am writing to formally request maternity leave in accordance with [Your Company Name]'s policies and the Family and Medical Leave Act (FMLA). My anticipated due date is [Month Day, Year], and I plan to commence my maternity leave on or around [Month Day, Year].

I understand the importance of providing adequate notice for such leaves and have attached my medical certification from my healthcare provider confirming my pregnancy and expected due date. I am committed to ensuring a smooth transition during my absence and will make every effort to complete any pending work before my leave begins.

Maternity Leave Details:

Start Date: [Month Day, Year]

Expected Return Date: [Month Day, Year]

Duration of Leave: 2 weeks (as per FMLA guidelines)

Reason for Leave: Pregnancy and childbirth

Status during Leave: I intend to use my accrued paid time off (if applicable) during this period to cover my leave. I understand that [Your Company Name] will continue my health insurance coverage during this time, and I will make arrangements to continue my share of the premiums, as required.

Work Arrangements During Leave:

During my absence, I am willing to discuss and plan for any work arrangements that may be necessary to ensure the smooth running of my responsibilities. Please let me know if any specific tasks or projects need to be delegated during my maternity leave, and I will work with my team to ensure a seamless transition.

Communication During Leave:

I intend to remain accessible via email, in case any urgent work-related matters arise that require my attention during my maternity leave. However, I kindly request that my colleagues only contact me in exceptional circumstances to allow me to fully focus on my recovery and bonding with my newborn.

Returning to Work:

I am committed to returning to work on [Month Day, Year] and will notify you promptly if there are any changes to this plan. I understand that I will be required to provide a medical certification confirming my fitness for work before resuming my duties.

Confidentiality:

I trust that [Your Company Name] will treat this request with the utmost confidentiality and sensitivity.

I appreciate your understanding and support in granting me this maternity leave. Please provide me with any necessary forms or documentation required to formalize this request. If you have any questions or require additional information, please feel free to contact me at [Your Number] or [Your Email].

Thank you for your prompt attention to this matter.

Sincerely,

[Your Name]

[Your Employee ID Number]

Attachments:

Medical Certification for Pregnancy

[Note: Include any relevant medical documents required by your company's policies.]

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