MEF Employment Act 1955 & Regulations
FIRST SCHEDULE
REGISTER OF MATERNITY LEAVE AND
ALLOWANCES (IC)
Serial Number of Claim .................
(Employment Act 1955)
(Section 44)
Place of employment ....................................................................................
PART A
(To be completed in respect of a female employee about to leave her
employment who reports that she knows or has reason to believe that she
will be confined within a period of four months from the date on which she
leaves her employment).
1. Name and National Registration Identification Card Number
.........................................................................................................
2. Future Address ................................................................................
3. Date of leaving employment ...........................................................
4. Date of notifying pregnancy ............................................................
5. Expected date of confinement .........................................................
6. Name, National Registration Identification Card Number and address
of nominee (if any) appointed to receive maternity allowance under
the provision of section 41
.........................................................................................................
7. Number of days employed during the
1st............................2nd...........................3rd...................................
4th...........................5th............................6th...................................
7th...........................8th............................9th ..................................
month preceding her departure.
Employment Act 1955 & Regulations MEF
PART B
(To be completed in respect of maternity leave and allowances under the
provisions of section 37).
1. Name and National Registration Identification Card Number
.........................................................................................................
2. Name, National Registration Identification Card Number and address
of nominee (if any)
.........................................................................................................
3. Date of notifying commencement of maternity leave .....................
.........................................................................................................
4. Date on which employee commenced her maternity leave .............
.........................................................................................................
5. Number of days employed during the
1st............................2nd...........................3rd...................................
4th...........................5th............................6th...................................
7th...........................8th............................9th...................................
month preceding her confinement.
6. Date of confinement ........................................................................
7. Date of notifying confinement .........................................................
8. Date on which work was resumed (or date of leaving the employment
or date of death) ..............................................................................
9. Number of consecutive days employee was on maternity leave:
(i) Prior to confinement ............................................................
(ii) After confinement ................................................................
10. Ordinary rate of pay of employee per day.......................................
11. Amount of maternity allowance and date of payment:
(i) Before confinement ..... ....... $...................................
(ii) After confinement ..... ....... $...................................
MEF Employment Act 1955 & Regulations
12. If maternity allowance is not paid or not paid in full, state here
the reasons
......................................................................................................
......................................................................................................
......................................................................................................
I confirm that the above particulars are correct.
.....................................................
Signature of Employer
I confirm that the amounts stated above have been paid to me.
........................................................................
Signature of Employee/Nominee
