Form GPCL1 "Government-Paid Childcare Leave (Gpcl) Scheme Declaration by Employee" - Singapore

Form GPCL1 or the "Government-paid Childcare Leave (gpcl) Scheme Declaration By Employee" is a form issued by the Singapore Ministry of Social and Family Development.

Download a PDF version of the Form GPCL1 down below or find it on the Singapore Ministry of Social and Family Development Forms website.

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Download Form GPCL1 "Government-Paid Childcare Leave (Gpcl) Scheme Declaration by Employee" - Singapore

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Form GPCL1
GOVERNMENT-PAID CHILDCARE LEAVE (GPCL) SCHEME
DECLARATION BY EMPLOYEE
Child Development Co-Savings Act (Cap. 38A)
Child Development Co-Savings (Leave and Benefits) Regulations 2017
Before filling up the form (which may take you 3 minutes to complete), please note:
(i)
Read the explanatory notes before completing this declaration.
(ii) Save for Part G below, all references to “you” or “I” in this form shall be taken to be a reference to you,
the employee who is applying for Childcare leave/ Extended Childcare leave.
Scheme applied for (please tick one)
 Childcare Leave (CCL)
 Extended Childcare Leave (ECL)
1
1
Part A : Details of Employee
A
Name
B
NRIC No. / FIN No. / Passport No.
C
Designation of employee
D
Date when employee joined company
Note:
If you are submitting this form to your employer for the first time for the current relevant period (referred to in Part D), you will
need to complete all the sections in the form. Otherwise, please proceed to Part D.
Part B : Details of Youngest Child of Employee
A
Name
B
Birth certificate No.
C
Date of birth
Part C : Declaration of Singapore citizenship
 Yes
 No
My youngest child is a Singapore citizen
Please attach a copy of the child’s Singapore citizenship certificate if the child is not born as
a Singapore citizen.
*delete where applicable
Part D : Details of Childcare Leave
2
The relevant period
agreed by both employer and you to take childcare leave/ extended childcare leave is as
follows:
Start
End
D
D
M
M
Y
Y
Y
Y
D
D
M
M
Y
Y
Y
Y
Note: The relevant period agreed upon will be used for the entire duration of childcare leave/extended childcare leave until the
1
Parents can start taking childcare leave (CCL) either (a) in the relevant period in which the child is born or (b) in the following
relevant period. For (a), parents may take up to 6 days of CCL per relevant period when the child is 0 – 6 years old and 2 days of
extended childcare leave (ECL) per relevant period when the child is 7 – 12 years old. For (b), parents may take up to 6 days of
CCL per relevant period when the child is 1 – 7 years old and 2 days of ECL per relevant period when the child is 8 – 13 years
old. When parents are eligible to take up to 6 days of CCL in a particular relevant period, in which they have a newborn, they will
be under (b) with respect to the newborn.
The “relevant period” refers to any period of 12 months as is agreed to by the employee and his employer; or where there is no
2
such agreement, a calendar year.
Updated July 2017
Page 1 of 5
Version 2017.1
Form GPCL1
GOVERNMENT-PAID CHILDCARE LEAVE (GPCL) SCHEME
DECLARATION BY EMPLOYEE
Child Development Co-Savings Act (Cap. 38A)
Child Development Co-Savings (Leave and Benefits) Regulations 2017
Before filling up the form (which may take you 3 minutes to complete), please note:
(i)
Read the explanatory notes before completing this declaration.
(ii) Save for Part G below, all references to “you” or “I” in this form shall be taken to be a reference to you,
the employee who is applying for Childcare leave/ Extended Childcare leave.
Scheme applied for (please tick one)
 Childcare Leave (CCL)
 Extended Childcare Leave (ECL)
1
1
Part A : Details of Employee
A
Name
B
NRIC No. / FIN No. / Passport No.
C
Designation of employee
D
Date when employee joined company
Note:
If you are submitting this form to your employer for the first time for the current relevant period (referred to in Part D), you will
need to complete all the sections in the form. Otherwise, please proceed to Part D.
Part B : Details of Youngest Child of Employee
A
Name
B
Birth certificate No.
C
Date of birth
Part C : Declaration of Singapore citizenship
 Yes
 No
My youngest child is a Singapore citizen
Please attach a copy of the child’s Singapore citizenship certificate if the child is not born as
a Singapore citizen.
*delete where applicable
Part D : Details of Childcare Leave
2
The relevant period
agreed by both employer and you to take childcare leave/ extended childcare leave is as
follows:
Start
End
D
D
M
M
Y
Y
Y
Y
D
D
M
M
Y
Y
Y
Y
Note: The relevant period agreed upon will be used for the entire duration of childcare leave/extended childcare leave until the
1
Parents can start taking childcare leave (CCL) either (a) in the relevant period in which the child is born or (b) in the following
relevant period. For (a), parents may take up to 6 days of CCL per relevant period when the child is 0 – 6 years old and 2 days of
extended childcare leave (ECL) per relevant period when the child is 7 – 12 years old. For (b), parents may take up to 6 days of
CCL per relevant period when the child is 1 – 7 years old and 2 days of ECL per relevant period when the child is 8 – 13 years
old. When parents are eligible to take up to 6 days of CCL in a particular relevant period, in which they have a newborn, they will
be under (b) with respect to the newborn.
The “relevant period” refers to any period of 12 months as is agreed to by the employee and his employer; or where there is no
2
such agreement, a calendar year.
Updated July 2017
Page 1 of 5
Version 2017.1
Form GPCL1
employee becomes ineligible (i.e. does not meet the eligibility criteria) or changes employer. If the employee changes employer
and is still eligible for childcare leave/ extended childcare leave, he/she may opt for a different relevant period with the new
employer.
Part D : Details of Childcare Leave (con’t)
Please indicate the date(s) which you will be taking the childcare leave/ extended childcare leave.
Monthly Salary
Leave Duration
Monthly Claimable
Monthly Employer
Leave Date(s)
(excluding
S/N
(Full-Day / Half-
Allowances
CPF Contribution
(DD/MM/YYYY)
allowances)
Day)
(S$)
(S$)
(S$)
1
2
3
4
5
6
Part E : Declaration of Leave Consumption
A. I have not applied for childcare leave/ extended childcare leave with my previous employer during the current
calendar year.
B. I have previously applied for childcare leave/ extended childcare leave with my previous employer(s) during
the current calendar year.
If you have selected box B, i.e. taken childcare leave/extended childcare leave at any time during the current
relevant period, please provide the details below.
Date(s) of childcare
Start date of
Last day of
leave/ extended
Name of previous
employment with
employment with
childcare leave taken
S/N
employer(s)
the previous
the previous
under the previous
employer
employer
employer (where
applicable)
Number of days of childcare leave/extended childcare leave taken with previous employer(s) for the current
calendar year : ___________
Updated July 2017
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Form GPCL1
Part F : Employee’s Declaration
I have read and understood the explanatory notes.
I hereby declare that all information given in this declaration is true, correct and complete.
I understand that –
a) if I knowingly make any false or misleading statement, or produce or furnish, or cause or knowingly allow to
be produced or furnished, any document which I know to be false or misleading in a material particular, I
shall be guilty of an offence under section 16 of the Child Development Co-Savings Act (Cap. 38A) (CDC
Act) and shall be liable on conviction to a fine not exceeding $20,000 or to imprisonment for a term not
exceeding 12 months or to both; and
b) my employer or the Government may recover from me any moneys paid out to me in reliance of a false or
misleading statement or document or by reason of a mistake of fact, pursuant to section 11 of the CDC Act.
________________________________
________________
_________________
_____________
Employee’s Name
NRIC No.
Signature
Date
Part G : Employer’s Acknowledgement
I understand that the 6 days of childcare leave is being granted to my employee with a Singapore citizen child
below the age of 7 years (regardless of the number of children below the age of 7 years) / I understand that the 2
days of extended child care leave is being granted to my employee whose youngest qualifying child is a
Singapore citizen and who is aged 7 years and above but below 13 years of age (regardless of the number of
children my employee has).
I have agreed to allow my employee (referred to in Part A) to take the childcare leave/extended childcare leave
on the dates stated in Part D.
____________________________
______________
_____________________
______________
Name & Designation
NRIC No.
Signature
Date
*Delete where applicable.
Note to employer:
Please do not submit this declaration form. However please keep this form for a period of 5 years from the
date the form is submitted to you by your employee, for verification of details if necessary.
Note to employee:
In completing this declaration, you have given consent to display the total number of days you have taken at
“View GPCL taken” in the Government-Paid Leave Portal. Should you have queries, please email us at
contactus@profamilyleave.gov.sg.
Updated July 2017
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Form GPCL1
EXPLANATORY NOTES ON DECLARATION BY EMPLOYEE
Declaration of eligibility
1. This form should be submitted by an employee who is the parent of the child in respect of whom childcare leave is
being applied for (“the child”) to his/her employer before the start of the childcare leave.
2. Subject to the Child Development Co-Savings Act (Cap 38A) (“CDC Act”) and the Child Development Co-Savings
(Leave and Benefits) Regulations 2017 (“CDC Regulations”), an eligible employee is entitled to :
a) 6 days of the childcare leave per relevant period, of which the first 3 days will be employer-paid and the last 3
days will be Government-paid so long as the employee has a Singapore citizen child
3
; and
b) 2 days of extended childcare leave per relevant period if the employee has a Singapore citizen child
3
.
3. The employee is entitled to receive payment from the employer at his/her gross rate of pay up to a maximum of
$500 for each day of childcare leave. The payment will include any CPF contributions which an employer is liable
to make under the Central Provident Fund Act (Cap. 36).
4. In making this declaration, the employee assures the employer that he/she meets the eligibility criteria for the
childcare leave benefits. An employee is eligible for paid childcare leave during a relevant period if:
a) he/she has served the employer for a continuous period of not less than 3 months; and
4
b) he/she has any child of the eligible age
, and
th
th
c) his/her child is a Singapore citizen, or who becomes, a Singapore citizen before the 7
or 12
birthday, at any
time during any relevant period.
5. If the employee did not serve the employer for the full 12 months during the relevant period, he/she shall be
entitled to childcare leave for that relevant period based on the table below –
Length of service with employer during relevant period
Number of days of childcare leave
Not less than 3 months but less than 5 months
2
Not less than 5 months but less than 7 months
3
Not less than 7 months but less than 9 months
4
Not less than 9 months but less than 11 months
5
Not less than 11 months
6
6. The child, in relation to an employee, includes any adopted child or step-child of the employee.
7. With effect from 1 May 2013, unmarried/ single parents are also eligible for childcare leave/ extended childcare
leave, subject to all other eligibility criteria for childcare leave in Paragraph 4 of these Explanatory Notes being
met.
8. An employee shall not be entitled to:
a) More than 42 days of childcare leave in respect of any qualifying child;
b) More than 12 days of extended childcare leave in respect of any qualifying child; and
c) More than a combined total of 6 days of childcare leave and extended childcare leave during any relevant
period.
9. If the employment of the employee who is entitled to childcare leave is terminated (whether by resignation or
dismissal, upon the completion of his contract of service, or for any other reason) before he has taken the
entitlement of childcare leave or extended childcare leave, as the case may be, for a relevant period, the
employee:
3
Parents can start taking childcare leave (CCL) either (a) in the relevant period in which the child is born or (b) in the following
relevant period. For (a), parents may take up to 6 days of CCL per relevant period when the child is 0 – 6 years old and 2 days of
extended childcare leave (ECL) per relevant period when the child is 7 – 12 years old. For (b), parents may take up to 6 days of
CCL per relevant period when the child is 1 – 7 years old and 2 days of ECL per relevant period when the child is 8 – 13 years
old. When parents are eligible to take up to 6 days of CCL in a particular relevant period, in which they have a newborn, they will
be under (b) with respect to the newborn.
Updated July 2017
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Form GPCL1
a) Shall cease to be entitled to that leave upon the termination of his employment; and
b) Shall not be entitled to any payment in lieu thereof.
Notes to Employers
10. Employers should ensure that they have received the duly signed and completed declaration form (GPCL1) or in
such form as in the employer may provide in accordance to the requirements specified in the website
www.profamilyleave.gov.sg/info, from their employee before making payment. If the employer is satisfied that the
employee is entitled to payment in accordance with paragraph 4 of these Explanatory Notes, he may proceed to
make payment to him/her.
11. Please do not submit this declaration form to the authorised agent of the Ministry of Social and Family
Development. However please keep this form, for a period of 5 years from the date the form is submitted to you
for verification of details. .
12. For
more
information
or
clarification,
please
contact
us
at
1800-253-4757
or
e-mail
to
contactus@profamilyleave.gov.sg. You can also visit our website at www.profamilyleave.gov.sg.
Updated July 2017
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