Use this form to apply to resolve a dispute about an extension of a period of unpaid parental leave.
On this page:
Who can use this form
Use this form if:
- you are an employee
- you have taken unpaid parental leave under the National Employment Standards
- you requested an extension of your unpaid parental leave for a further period of up to 12 months
- you made your request on or after 6 June 2023
- your employer has:
- refused your request or
- not responded to your request and it has been more than 21 days since you made the request
- you have tried to resolve the dispute by discussions with your employer
- you want us to help you resolve the dispute.
Before you start
Have this information ready before you begin this form. You will need to tell us:
- your contact details
- details of a legal representative or paid agent, if you have one
- your employer’s details, including a contact person
- details of your employment, including when you started working for them
- the date you started your parental leave
- the date you were originally due to return to work
- the amount of extra time you asked for
- if your employer responded, details of their response including their reasons for refusing the request
- details about how you have tried to resolve the issue with your employer
- the outcome you want from this application.
You will also need to include a copy of:
- your written request
- your employer’s written response, if they gave you one.
We store your information in line with the Form F10B privacy notice (pdf).
Apply now
Email your completed form to [email protected].
You can also send or deliver your application to the Commission office near you.
What happens next
After we receive your form, we will let your employer know that you have started a dispute case about your request for an extension of unpaid parental leave.
We will send a copy of this form as well as any other documents you have sent us to your employer. This is so they can understand your side of the case.
Your case will then be given to a Commission Member, who will decide how your case will proceed. They might decide to hold a conference or hearing, or they might ask you for more information.
Rules and regulations for this form
Fair Work Act 2009 : Section 76B