Paternity Benefit: Employer Certificate Application Form (PB2)

Published date23 March 2021
IssuerDepartment of Social Protection
Employer Certicate for
Paternity Benet Data Classication R
Social Welfare Services
PB 2
Page 1
If you are employed, your employer must complete this form to certify you are
entitled to paternity leave for the dates provided.
PPSN of employee:
Name of employee:
Expected due date of
baby: D D M M Y Y Y Y
Paternity Leave
Start Date:
Paternity Leave
End Date:
Employer’s Payment Method Details
Note: This section should only be completed if your employee has authorised that Paternity Benet
payments will be made directly to you.
D D M M Y Y Y Y
From:
D D M M Y Y Y Y
To:
or
Financial Institution
Name of financial
institution:
Bank Identifier Code (BIC):
International Bank Account
Number (IBAN):
Account Name(s):
Note: You will find the following details required below printed on statements from your financial
institution.
Child’s date of
birth: D D M M Y Y Y Y
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.
If you make any alterations after you complete the form, you must initial and date them
otherwise the information supplied cannot be accepted.

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