SC3 SSP Declaration 230821 124728

Statutory Paternity Pay/paternity leave
Becoming a parent Your dates for pay and leave

If you want to take time off work to support the mother of the Give the date the baby is due.
baby or look after the baby you may be entitled to: If the baby has already been born, give the date the baby
• Statutory Paternity Pay (SPP) — at least part of your wages was due and the actual date of birth.
will be paid for two weeks. You will get the weekly rate of Due date DD MM YYYY
SPP current at the time of your paternity leave, or 90% of
your average weekly earnings, whichever is less
• paternity leave — up to two weeks time off.
Actual date of birth (if applicable)
Please read through the terms and conditions below and if you
think you might qualify, fill in the form opposite and complete
the declaration on page 2. If you need help, please contact any
I would like my SPP and/or paternity leave to start on the date
HM Revenue & Customs office. You can find the phone number
the baby is born
in The Phone Book under ‘HM Revenue & Customs’.
Terms and conditions No Yes

SPP and paternity leave are available to: If ‘No’, I would like my SPP to start within eight weeks of the
• a biological father date the baby was born starting on or around
• a partner, husband or civil partner that is not the baby’s
biological father.
You must be able to declare that: If ‘Yes’, you cannot attend work for any part of that day.
• you are
I want to be away from work for
— the baby’s biological father, or
— married to or in a civil partnership with the mother, or
One week
— living with the mother in an enduring family relationship,
but are not an immediate relative, and
Two weeks
• you will be responsible for the child’s upbringing, and
• you will take time off work to support the mother or care Surname or family name
for the child.
You must be continuously employed by the same employer
during the whole of the pregnancy. First name(s)
To get SPP you must also have average earnings over a set
period above a set amount — your employer will work this out
for you. You cannot start your paternity leave before the child National Insurance number
is born.
You can choose to take one or two whole weeks leave, but not
two separate weeks, which must end by the 56th day after the Please turn over
date of birth. If the baby is born early you can choose to take
your leave any time between the actual date of birth and the
end of an eight week period starting from the Sunday of the
week the baby was originally due. You cannot take odd days
off work, but the weeks can start on any day, for example,
from Tuesday to Monday.
You must discuss your leave plans with your employer and tell
them what time off you want by the 15th week before the
week the baby is due. Your employer can tell you when this is
if you are not sure.
You can change your mind, but you must give your employer
28 days notice of the dates. If you do change your mind, you
and your employer may find it helpful if you filled in a new
form SC3 Statutory Paternity Pay/paternity leave.
If you cannot tell your employer what time off you want in
time, or the baby is born sooner or later than expected, please
discuss the situation with your employer. If you are unable to
resolve any disagreement contact any HM Revenue & Customs
office for advice.
SC3 Page 1 HMRC 08/08

Your declaration Disagreements
You must be able to tick all three boxes below to get If your employer tells you that you are not entitled to SPP
Statutory Paternity Pay and paternity leave. and/or paternity leave you can challenge that decision. If you
need help with this, for:
I declare that:
• SPP — contact any HM Revenue & Customs office
• I am
• paternity leave — phone the Advisory Conciliation and
– the baby’s biological father, or
Arbitration Service (Acas) Helpline number
– married to or in a civil partnership with
08457 47 47 47. In Northern Ireland, phone the
the mother, or
Labour Relations Agency on 028 9032 1442.
– living with the mother in an enduring family
relationship, but am not an immediate Penalties
relative, and Penalties may be charged where a person, either fraudulently
or negligently, gives incorrect information or makes a false
• I will have responsibility for the child’s statement or declaration for the purpose of claiming
upbringing, and entitlement to statutory adoption, paternity, maternity or
sick pay.
• I will take time off work to support the mother
or care for the child.
Signature
Date DD MM YYYY
Give this form to your employer, but keep a copy of the terms
and conditions for your records.
Further information and help

We have not covered all of the law that relates to SPP and
paternity leave on this form. So if you are in any doubt
about your entitlement talk to your employer or contact
any HM Revenue & Customs office.
Depending on your circumstances you may not qualify for
SPP and/or paternity leave. Your employer will let you know.
If this is the case you will get more advice and information at
the time.
You can also:
• go to www.direct.gov.uk/workandfamilies or
• contact any Advisory Conciliation and Arbitration Service
(Acas) office for more information about paternity leave and
other employment rights. Phone Acas on 08457 47 47 47 or
go to www.acas.org.uk
The Department for Work and Pensions publication NI17A
A guide to Maternity Benefits also has details of other
booklets covering social security benefits and some brief
information on paternity. Go to
www.dwp.gov.uk/advisers/#techguides
Information on all aspects of employment legislation is also
usually available from any Citizens Advice Bureau, low pay
units and Trade Unions. If you are not entitled to SPP you
may be entitled to other government help. Contact any
Jobcentre Plus office for further information.
Page 2

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SC3 SSP Declaration 230821 124728

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Statutory Paternity Pay/paternity leave

Becoming a parent Your dates for pay and leave

Terms and conditions No Yes

SC3 Page 1 HMRC 08/08

Further information and help

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