Payroll (assignment) number: _ _ _ _ _ _ _ _ Type of Leave: Maternity / Additional Maternity Support (Paternity) / Adoption Leave (delete as appropriate.) Date Week Start time Finish time Total hours Please indicate: number of worked time in lieu or leave (excluding payment breaks) Employee signature: ............................................................... signature: .............................................................. Manager’s Once signed by both employee and Manager, please forward a copy to:- Human Resources Team, North Yorkshire & Humber CSU, Health House, Grange Park Lane, Willerby, HU10 6DT
Payroll (assignment) number: _ _ _ _ _ _ _ _ Type of Leave: Maternity / Additional Maternity Support (Paternity) / Adoption Leave (delete as appropriate.) Date Week number of leave Start time Finish time Total hours worked (excluding breaks) Please indicate: time in lieu or payment Employee signature: ............................................................... Manager’s signature: .............................................................. Once signed by both employee and Manager, please forward a copy to:- Human Resources Team, North Yorkshire & Humber CSU, Health House, Grange Park Lane, Willerby, HU10 6DT
adoption-leave-appendices.docx