Skip to main content

Maternity Leave Form (Nigeria)

Maternity Leave Form (Nigeria)

MATERNITY LEAVE APPLICATION FORM

Labour Act (Cap L1, LFN 2004), Section 54 | Federal Government Public Service Rules 2008

Date of Application: [Application Date]

To: Human Resources Department, [Employer Name]

1. EMPLOYEE DETAILS

Full Name: [Employee Name]

Staff ID: [Staff ID]

Department: [Department]

Job Title: [Job Title]

Date of Employment: [Date of Employment]

2. MATERNITY LEAVE DETAILS

Expected Date of Delivery (EDD): [Expected Delivery Date]

Requested Leave Start Date: [Leave Start Date]

Requested Leave End Date: [Leave End Date]

Total Weeks Requested: [Total Weeks] weeks

Attending Doctor / Midwife: [Doctor Name]

Hospital / Clinic: [Hospital]

I attach herewith a medical certificate from my attending doctor confirming my pregnancy and expected delivery date, as required by Section 54(2) of the Labour Act (Cap L1, LFN 2004).

3. HANDOVER AND PAY ARRANGEMENTS

Acting Officer during Leave: [Acting Officer]

Handover Notes: [Handover Notes]

Pay Arrangement: [Pay Arrangement]

4. DECLARATION

I, [Employee Name], hereby apply for maternity leave as detailed above. I confirm that the information provided is accurate and that I will provide a copy of my delivery certificate to the Human Resources Department within 4 weeks of delivery.

I am aware that my employment is protected during maternity leave under Section 54(1) of the Labour Act (Cap L1, LFN 2004) and that I am entitled to return to the same or equivalent position upon expiry of my leave.

Employee

________________

Signature

Direct Supervisor

________________

Signature

HR Manager

________________

Signature

Maintained by Vladislav Sergienko, Founder·Template last modified: ·Report an error

What Is a Maternity Leave Form (Nigeria)?

A Maternity Leave Form in Nigeria organises the details a party must supply for the purpose it serves.

The Labour Act (Cap L1, LFN 2004) applies primarily to workers in the private sector employed under contracts of service in Nigeria. Section 54(1) specifically provides that an employer shall not give notice to terminate a female employee's employment during maternity leave, making maternity leave protection an anti-dismissal safeguard as well as a benefit. However, the Labour Act does not apply to civil servants, whose maternity entitlements are governed by the federal or state public service rules — the Federal Government of Nigeria's Public Service Rules (PSR) 2008 provide for 3 months' (12 weeks') maternity leave for federal civil servants.

For private sector employees, the National Industrial Court of Nigeria (NICN) — established under the National Industrial Court Act 2006 and granted exclusive jurisdiction over labour matters by the Third Alteration to the Constitution of the Federal Republic of Nigeria 1999 (as amended) — adjudicates disputes arising from unlawful denial of maternity leave or wrongful termination during maternity leave. The NICN has, in cases such as Ebeere v. First Bank of Nigeria Plc [2018], affirmed women's right to full maternity benefits and held that termination during maternity leave is unlawful.

Several states have enacted labour laws supplementing the federal Labour Act with enhanced maternity provisions. Lagos State has not enacted a separate maternity law but enforces the federal provisions. The Violence Against Persons (Prohibition) Act 2015 (VAPP) and the Constitution of the Federal Republic of Nigeria 1999, Section 42 (freedom from discrimination), support maternity protection as a gender equality right.

The legal framework governing the Maternity Leave Form (Nigeria) in Nigeria draws on several key statutes and regulatory bodies. Under Nigerian law, the Companies and Allied Matters Act 2020 (CAMA) regulates corporate entities through the Corporate Affairs Commission (CAC). The Labour Act (Cap L1 LFN 2004) and the National Industrial Court of Nigeria (NICN) govern employment disputes. The Nigeria Data Protection Regulation (NDPR) 2019 and the Nigeria Data Protection Commission (NDPC) protect personal data. The Federal Inland Revenue Service (FIRS) administers tax obligations under the Companies Income Tax Act. The Federal High Court and state High Courts have jurisdiction over civil matters. Parties executing a Maternity Leave Form (Nigeria) in Nigeria should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Labour Act (Cap. L1, LFN 2004) sets the foundational requirements.

When Do You Need a Maternity Leave Form (Nigeria)?

A Maternity Leave Form in Nigeria is required whenever a female employee in the private sector, public service, or parastatal organisation needs to formally notify her employer of her intention to take maternity leave and obtain approval.

A Maternity Leave Form is needed when a private sector employee — working in a bank, manufacturing company, oil and gas firm, or any employer covered by the Labour Act (Cap L1, LFN 2004) — is pregnant and wishes to formally apply for her 12-week statutory maternity leave entitlement under Section 54 of the Labour Act.

A Maternity Leave Form is required when a federal civil servant seeks to take the 3-month maternity leave entitlement provided under the Federal Government Public Service Rules 2008. The form is submitted to the employee's supervising officer and the Head of Department for approval.

A Maternity Leave Form is needed when an employee working in a state government ministry or parastatal applies for maternity leave under the relevant state public service rules or the Employee Handbook applicable to that institution.

A Maternity Leave Form is required when an employee wants to document her expected delivery date, the start and end dates of her maternity leave, the designation of any acting officer during her absence, and the arrangement for payment of her maternity allowance under the employer's policy.

A Maternity Leave Form is needed to create a formal HR record that protects the employee from unlawful termination during maternity leave under Section 54(1) of the Labour Act and Section 42 of the Constitution of the Federal Republic of Nigeria 1999.

Parties in Nigeria should prepare a Maternity Leave Form (Nigeria) proactively rather than waiting for a dispute to arise. Courts interpret agreements based on the written terms rather than oral representations. Under Nigerian law, the Companies and Allied Matters Act 2020 (CAMA) regulates corporate entities through the Corporate Affairs Commission (CAC). The Labour Act (Cap L1 LFN 2004) and the National Industrial Court of Nigeria (NICN) govern employment disputes. The Nigeria Data Protection Regulation (NDPR) 2019 and the Nigeria Data Protection Commission (NDPC) protect personal data. The Federal Inland Revenue Service (FIRS) administers tax obligations under the Companies Income Tax Act. The Federal High Court and state High Courts have jurisdiction over civil matters. Where the transaction involves regulated activities, prior approval from the relevant authority may be required before execution.

What to Include in Your Maternity Leave Form (Nigeria)

A valid Nigeria Maternity Leave Form must contain the following essential elements.

Employee Details: Full name, employee number or staff ID, department, job title, and date of commencement of employment. The employee's NIN (National Identification Number) issued by NIMC may also be required for payroll processing.

Expected Delivery Date: The expected date of delivery (EDD) as certified by a registered medical practitioner or midwife. Under Section 54 of the Labour Act (Cap L1, LFN 2004), the 12-week entitlement is split into pre-delivery leave (at least 6 weeks before EDD) and post-delivery leave (at least 6 weeks after delivery).

Requested Leave Dates: The proposed start and end dates of maternity leave. The employee may choose to start pre-delivery leave earlier than 6 weeks before the EDD if medically indicated or if the employer's policy permits.

Medical Certificate: Attachment of a medical certificate from a registered medical practitioner or midwife (licensed by the Medical and Dental Council of Nigeria, MDCN) confirming the pregnancy and expected delivery date, as required by Section 54(2) of the Labour Act.

Pay During Maternity Leave: Confirmation of the maternity pay arrangement — whether the employer pays full salary during the 12-week period (as required by Section 54(3) of the Labour Act for the statutory minimum), enhanced pay under the employer's policy, or whether the employee will claim from the National Health Insurance Authority (NHIA) or National Social Insurance Trust Fund (NSITF) under NSITF Act (Cap N133, LFN 2004) if covered.

Handover Arrangements: The name of the person acting in the employee's role during the leave period, and any handover documentation to be prepared before the leave commences.

Supervisor and HR Approval: Signatures of the employee's direct supervisor and the Human Resources department confirming the leave dates and pay arrangements.

Additional compliance elements for a Maternity Leave Form (Nigeria) used in Nigeria include: Under Nigerian law, the Companies and Allied Matters Act 2020 (CAMA) regulates corporate entities through the Corporate Affairs Commission (CAC). The Labour Act (Cap L1 LFN 2004) and the National Industrial Court of Nigeria (NICN) govern employment disputes. The Nigeria Data Protection Regulation (NDPR) 2019 and the Nigeria Data Protection Commission (NDPC) protect personal data. The Federal Inland Revenue Service (FIRS) administers tax obligations under the Companies Income Tax Act. The Federal High Court and state High Courts have jurisdiction over civil matters. Forms-legal.com provides this template as a starting point for Nigeria-compliant documentation.

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). Maternity Leave Form (Nigeria) (Nigeria) [Legal document template]. Forms Legal. https://forms-legal.com/nigeria/employment/hr-forms/maternity-leave-form-nigeria

MLA

"Maternity Leave Form (Nigeria) (Nigeria)." Forms Legal, 2026, https://forms-legal.com/nigeria/employment/hr-forms/maternity-leave-form-nigeria.

BibTeX
@misc{formslegal-maternity-leave-form-nigeria,
  author       = {{Forms Legal}},
  title        = {Maternity Leave Form (Nigeria) (Nigeria)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/nigeria/employment/hr-forms/maternity-leave-form-nigeria}},
  note         = {Free legal document template. Based on Labour Act (Cap. L1, LFN 2004)}
}

Also available for these jurisdictions:

Frequently Asked Questions

Based on Labour Act (Cap. L1, LFN 2004) — Template last modified June 2026

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

Found an error? Let us know