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Maternity Leave Application

A maternity leave application is submitted by a pregnant employee to inform the employer of her expected date of delivery and the period of maternity leave she will take. It supports the claim for maternity benefit and helps HR plan cover and payroll.

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[Company Logo][Company Name]

APPLICATION FOR MATERNITY LEAVE

Date:: [Date]

To,
The HR Manager
[Company Name]
[Company Address]

Copy: [Reporting Manager]

Subject: Application for Maternity Leave

Dear [HR Name],

I am pleased to inform you that I am expecting a child, and my expected date of delivery is [DD/MM/YYYY], as per the enclosed certificate from [Doctor Name / Hospital Name].

I request maternity leave from [DD/MM/YYYY] to [DD/MM/YYYY], a total of [Number] weeks, in accordance with the maternity benefit provisions applicable to me and the company policy. Of this, I propose to take [Number] weeks before the expected date of delivery and the balance after delivery.

Particulars	Details
Expected date of delivery	[DD/MM/YYYY]
Leave start date	[DD/MM/YYYY]
Leave end date	[DD/MM/YYYY]
Number of surviving children before this delivery	[Number]
ESI coverage	[Yes – IP No. Number / No]
Additional leave requested after benefit period	[Number] days of [Leave Type] / Not applicable

Enclosures:

Medical certificate stating the expected date of delivery
[Any other document required by HR]

Before going on leave, I will hand over my responsibilities to [Colleague Name] and share a status note on [Projects / Tasks]. I will inform HR of the actual date of delivery within a reasonable time and submit the birth certificate or discharge summary as required. [After the leave, I would like to discuss working from home for Number weeks, if the nature of my work permits.]

Kindly sanction the leave and advise me on the benefit payment process.

Yours sincerely,

[Employee Name]
Employee ID: [Employee ID]
[Designation], [Department]
Phone: [Mobile Number]

For HR Use

Eligibility verified	[ ] Yes
Leave sanctioned from [DD/MM/YYYY] to [DD/MM/YYYY]
Benefit payable by	[ ] Employer [ ] ESIC

HR
[HR Name]
Date: [Date]

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What this template includes

Expected date of delivery supported by a medical certificate
Proposed start and end dates of maternity leave
Number of surviving children, which affects entitlement under the law
Request regarding pre-delivery leave and post-delivery leave split
Benefit payment details (employer or ESI)
Plan for handover and return, including any work-from-home request

When to use it

Before the expected date of delivery, once the leave start date is decided
When a doctor advises leave earlier than planned
ESI-covered employees who also need to inform the employer
Combining maternity leave with other leave or work-from-home after the benefit period

How to customise this template

1Enter dates from your doctor's certificate
2Check your current entitlement with HR before stating the number of weeks
3Select whether you are covered by ESI or by the employer's maternity benefit
4Add a request for work from home after the leave if your role allows

HR tips

Inform HR early so that cover and payroll can be planned
Keep copies of all medical certificates submitted
Employers must not reduce benefits or terminate employment because of pregnancy or maternity leave
Check the company's crèche facility rules if applicable

Maternity benefit in India was governed by the Maternity Benefit Act, 1961, which provides up to 26 weeks for eligible women with fewer than two surviving children; these provisions are now part of the Code on Social Security, 2020. Verify current entitlement, eligibility and procedure with HR and the applicable rules before relying on this template.

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Frequently asked questions

How many weeks of maternity leave are allowed in India?+

Under the Maternity Benefit Act, 1961, as amended, eligible women with fewer than two surviving children can take up to 26 weeks, with lower entitlement in other cases. These provisions now sit in the Code on Social Security, 2020; check current rules with HR.

When should I apply for maternity leave?+

Apply as soon as you know your expected delivery date and planned start date, with a doctor's certificate. Early notice helps HR plan cover and process benefits on time.

Can maternity leave be combined with other leave?+

Many employers allow earned leave or work from home to be added after the maternity benefit period, subject to policy and approval. Mention this in the application.

Who pays maternity benefit for ESI-covered employees?+

For ESI-covered employees, maternity benefit is generally paid by ESIC, subject to eligibility. Others receive it from the employer. Confirm with HR which applies to you.

All 50 leave management →

[Company Logo][Company Name]

LEAVE APPLICATION FORM

Company:: [Company Name]
Form No.:: [Reference Number]
Date of Application:: [Date]

Part A – Employee Details

Employee Name
Employee ID
Designation
Department
Reporting Manager
Work Location
Mobile Number

Part B – Leave Details

Type of Leave	[ ] Casual [ ] Sick [ ] Earned/Privilege [ ] Compensatory Off [ ] Leave Without Pay [ ] Other: [Specify]
From Date (DD/MM/YYYY)
To Date (DD/MM/YYYY)
Number of Working Days
Half Day	[ ] First Half [ ] Second Half [ ] Not Applicable
Reason for Leave
Address and Phone Number During Leave

Part C – Work Handover

Form · Word

Leave Application Form

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[Company Logo][Company Name]
CASUAL LEAVE APPLICATION
Date:
[Date]
To,
[Reporting Manager]
[Designation]
[Department]
[Company Name], [Work Location]
Subject: Application for Casual Leave on [DD/MM/YYYY] [to DD/MM/YYYY]
Dear Sir / Madam,
I request casual leave for [Number] day(s) on [DD/MM/YYYY] [to DD/MM/YYYY] to attend to [a personal matter / a family function / documentation work at a government office].
I have completed or handed over my pending work as follows:
Letter · Word
Casual Leave Application
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[Company Logo][Company Name]
SICK LEAVE APPLICATION
Date:
[Date]
To,
[Reporting Manager]
[Department]
[Company Name]
Subject: Application for Sick Leave from [DD/MM/YYYY] to [DD/MM/YYYY]
Dear [Reporting Manager],
I was unwell with [fever / viral infection / a medical condition] from [DD/MM/YYYY] and, on the advice of my doctor, was unable to attend office. I had informed you by [phone / message / email] on [DD/MM/YYYY] at [Time].
I request that my absence from [DD/MM/YYYY] to [DD/MM/YYYY], a total of [Number] working days, be treated as sick leave.
Letter · Word
Sick Leave Application
Download .docx
[Company Logo][Company Name]
EARNED LEAVE APPLICATION
Date:
[Date]
To,
[Reporting Manager]
[Designation]
[Company Name]

Through: HR Department
Subject: Application for Earned Leave from [DD/MM/YYYY] to [DD/MM/YYYY]
Dear [Reporting Manager],
I wish to apply for earned leave of [Number] days from [DD/MM/YYYY] to [DD/MM/YYYY] for [a family vacation / a visit to my native place / personal commitments]. I request permission to [prefix / suffix] the holiday / weekly off on [DD/MM/YYYY] to this leave, as permitted under the leave policy.
Particulars Details
Earned leave balance as on date [Number] days
Leave applied [Number] days
Balance after leave [Number] days
Date of rejoining [DD/MM/YYYY]
Letter · Word
Earned Leave Application
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Particulars	Details
Earned leave balance as on date	[Number] days
Leave applied	[Number] days
Balance after leave	[Number] days
Date of rejoining	[DD/MM/YYYY]

[Company Logo][Company Name]

PRIVILEGE LEAVE APPLICATION FORM

Establishment:: [Company Name]
Unit / Plant:: [Work Location]
Application No.:: [Reference Number]
Date:: [Date]

A. Worker / Employee Details

Name	[Employee Name]
Token / Employee No.	[Employee ID]
Department / Section	[Department]
Designation / Grade	[Designation]
Shift	[ ] General [ ] A [ ] B [ ] C
Date of Joining	[Date of Joining]

B. Leave Applied

Period: From [DD/MM/YYYY] To [DD/MM/YYYY]
Number of days	[Number]
Holidays / weekly offs falling within the period	[Dates]
Purpose	[Purpose]
Address during leave	[Address]
Advance wages requested	[ ] Yes [ ] No

I request privilege leave for the above period. I will report for duty in my shift on [DD/MM/YYYY].

Form · Word

Privilege Leave Application

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[Company Logo][Company Name]
APPLICATION FOR PAID LEAVE
Date:
[Date]
To,
The HR Department
[Company Name]
[Company Address]

Copy: [Reporting Manager]
Subject: Request for Paid Leave from [DD/MM/YYYY] to [DD/MM/YYYY]
Dear Sir / Madam,
I request paid leave of [Number] working days from [DD/MM/YYYY] to [DD/MM/YYYY] for [personal reasons / travel / family commitments]. As per my latest leave statement, my available paid leave balance is [Number] days.
I request that this leave be processed with full pay for the month of [Month, Year]. In case my balance is found to be insufficient, please:
Letter · Word
Paid Leave Application
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[Company Logo][Company Name]
APPLICATION FOR LEAVE WITHOUT PAY
Date:
[Date]
To,
[Reporting Manager]
[Department], [Company Name]

Copy: HR Department
Subject: Request for Leave Without Pay from [DD/MM/YYYY] to [DD/MM/YYYY]
Dear [Reporting Manager],
I request leave without pay for [Number] days from [DD/MM/YYYY] to [DD/MM/YYYY]. I need this time because [brief reason, e.g. care of a family member / completion of a personal legal matter / relocation of my family].
I have checked my leave balances and confirm that my casual, sick and earned leave are [exhausted / not sufficient for this period]: CL [Number], SL [Number], EL [Number].
Letter · Word
Unpaid Leave Application
Download .docx
[Company Logo][Company Name]
PATERNITY LEAVE APPLICATION
Date:
[Date]
To,
[Reporting Manager]
[Department]
[Company Name]

Copy: HR Department
Subject: Application for Paternity Leave
Dear [Reporting Manager],
My wife / partner, [Spouse Name], is expecting our child, with the expected date of delivery on [DD/MM/YYYY] [/ delivered our child on DD/MM/YYYY]. I request paternity leave of [Number] days as provided under the company's paternity leave policy.
Leave requested: From [DD/MM/YYYY] To [DD/MM/YYYY]
[ ] Single block [ ] Split [Number] days from [DD/MM/YYYY] and [Number] days from [DD/MM/YYYY]
Additional earned leave requested [Number] days / None
Letter · Word
Paternity Leave Application
Download .docx

Leave requested: From [DD/MM/YYYY] To [DD/MM/YYYY]
[ ] Single block [ ] Split	[Number] days from [DD/MM/YYYY] and [Number] days from [DD/MM/YYYY]
Additional earned leave requested	[Number] days / None

Maternity Leave Application

Preview of the letter

Subject: Application for Maternity Leave

For HR Use

What this template includes

When to use it

How to customise this template

HR tips

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Frequently asked questions

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