Maternity leave application — sample 2026
An application to the head for pregnancy and maternity leave, based on the certificate of temporary incapacity.
Create in 2 minutesWhat the document contains
- The head of the organisation and the employee with position
- The request: leave from the date in the medical certificate of temporary incapacity, for the duration it states
- Attachment: the certificate of temporary incapacity (with its number)
- Date and signature
What to know before signing
- The leave is 140 days (70 before and 70 after birth), 155 days after a complicated delivery and 180 days for multiple births.
What to attach
- Certificate of temporary incapacity (with number and date)
Legal basis
- ՀՀ աշխատանքային օրենսգիրք, հոդված 172
This page is general information, not legal advice. Check the document against your own situation before using it; for a complex case, consult a lawyer.