I agree to return to work with the PCT/another employing authority after my Maternity leave for a period of not less than three months. I understand that if I fail to return to the PCT no later than 12 months, or to another employing authority no later than15 months, from the beginning of my Maternity Leave I shall be liable to repay the whole of the Maternity Pay less any SMP to which I have been entitled. Signature:…………………………………………… Date:………….…………… Entitlement 1c I wish to leave my decision on whether or not to return to work until after the birth of my baby. I understand that my right to return to work is protected and hereby agree in the case of Entitlement 1 that: I will not receive maternity pay from the PCT in excess of 6 weeks at 9/10ths I understand that if I return to work all outstanding monies in excess of 6 weeks will be paid to me in full. Signed:…………………………………………………… Date:………………… Entitlement 2 If you do not meet the service requirements for either (a) or (b) under Entitlement 1 I wish to apply for 52 weeks unpaid Maternity Leave commencing on Date…….………………….…….. I agree to return to work with the PCT/another employing authority after my Maternity Leave for a period of not less than three months. Signed:…………………………………………………… Date:………………… Entitlement 3 I wish to resign from my post following Maternity Leave. I understand that my contract will cease on the expiry of my maternity pay (Resignation Letter Attached). Signed:…………………………………………………… Date:…………………
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