Form Pb 2 - Employer Certificate For Paternity Benefit printable pdf download

Form Pb 2 - Employer Certificate For Paternity Benefit

Social Welfare Services

Employer Certificate

PB 2

for Paternity enefit

Data Classification R

If you are employe , your employer must complete this form to certify you are entitled to

paternity leave for the dates provided.

Note: If an employee is applying for paternity leave before their baby is born, they should supply the

expected due date of their baby. Otherwise, the baby’s date of birth can be provided.

PPSN of employee:

Name of employee:

Expected due date of

baby:

D D

M M

Y Y Y Y

Child’s date of

birth:

D D

M M

Y Y Y Y

Paternity Leave

From:

Start Date:

D D

M M

Y Y Y Y

Paternity Leave

To:

End Date:

D D

M M

Y Y Y Y

Employer’s Payment Method Details

This section should only be completed if your employee has authorised that Paternity Benefit payments

will be made directly to you.

Financial Institution

You will find the following details printed on statements from your financial institution.

Name of financial institution:

Bank Identifier Code (BIC):

International Bank Account

Number (IBAN):

Account Name(s):

Page 1

Form Pb 2 - Employer Certificate For Paternity Benefit

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