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Paid Parental Leave (PPL) Request Form

Sample Template for paid Parental Leave Request form Attachment 2 paid Parental Leave (PPL) Request form Identifying Information Employee name Phone numbers (personal and work) Email addresses (personal and work) Name of organization (agency, office, division, branch, etc.) Plans for Substituting paid Parental Leave (PPL) for FMLA Leave Reason FMLA Leave is being requested: Birth of a child Placement for adoption Foster care placement Anticipated Actual Date of birth or placement Date use of PPL begins Date use of PPL concludes Date of planned return to duty (after use of other types of Leave ) Requested method of using PPL: Continuous use Intermittent use* *Reason(s) intermittent Leave is being requested: *Describe pla

Paid Parental Leave (PPL) Request Form Identifying Information Employee name Phone numbers (personal and work) Email addresses (personal and work) Name of organization …

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