Nullstill

Applying for parental benefit, lump-sum grants or your maternal or

paternal quota upon a birth or adoption
The mother and father must apply separately. You cannot submit a joint application.

(The figures in brackets apply to births and assumption of parental rights in an adoption up to 1 July 2014)

The total benefit period for parental benefit is 49 weeks with 100% coverage, or 59 weeks with 80% coverage. Parental benefit
can be claimed no earlier than 12 weeks and no later than 3 weeks before your due date. This period is reserved for the mother.
A further 10 (14)-week maternal quota is also reserved for the mother. The first 6 weeks after both are included in this quota. If
the father is also entitled to parental benefit, a 10 (14)-week paternal quota is reserved for him. The father may start claiming no
earlier than 6 weeks after the birth. The rest of the parental benefit period, 26 (18) weeks at 100% coverage and 36 (28) weeks at
80% coverage, is a shared period which the parents are free to split between them. The entire benefit period must be continuous. If you do not want the period to be continuous, you can apply for a postponement. This means that if, for example, the father
wants to postpone his paternal quota, he must apply for this no later than on the last day of the shared period in order not to lose
days of benefit. Applications for postponements must be submitted using a special form, Postponement or graduated parental
benefit (flexible benefit) - NAV 14-16.05, which you can find on Nav.no.

1. What are you applying for?

Parental benefit and
the mothers maternal
quota - birth
Parental benefit and
the mothers maternal
quota - adoption

Lump-sum grant on
birth

Paternal quota for

father on birth

Parental benefit for

father on birth

Lump-sum grant on
adoption

Paternal quota for

father on adoption

Parental benefit for

father on adoption
Parental benefit for
father with sole care
on birth/adoption

Parental benefit for

mother with sole care
on birth/adoption

Norwegian national identity number

1.1 Name of applicant

(fdselsnummer) (11 digits)

1.2 Address of applicant

Telephone number

Street/road

Home

Post code

Mobile

Town

Work

1.3 Do you live in Norway?

Yes

No

Have you lived in Norway continuously for the last 12 months? Short
holidays abroad are not considered to be living abroad.
Yes

No
If no, in which country have you been resident,
and in which period?

Will you live in Norway continuously for 12 months or more? Short holidays
abroad are not considered to be living abroad.
Yes

No
If no, in which country will you be resident,
and in which period?

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2. Paid work

When you apply for parental benefit, you list your employment during the last ten months prior to the date for
withdrawal of the benefit. In addition you give the last gross amount before the leave begins. If you apply for postponement of the period with parental benefit / paternal quota, you must document employment and income at the
time when you apply for postponement (tic off weekly, fortnightly or monthly disbursement):
Selfemployed Earned
income

Employee

% position

Period

week

Employer or business
activity

14 days
month

day month

year

day

month

year

If you are an employee, your employer must submit details of your income on NAV form 08-30.01

2.1 Equivalent to paid work

Sickness benefit (sykepenger), attendance allowance (pleiepenger), care benefit (omsorgspenger), work
capacity assessment allowance (arbeidsavklaringspenger), pregnancy benefit (svangerskapspenger) or
parental benefit (foreldrepenger)
Unemployment benefit (dagpenger)
Period
day

Pay from employer while undergoing

training (lnn under utdanning)
Pay from employer after termination
of employment (etterlnn)
Military or civil conscript service

month

year

day

month

year

Severance pay (ventelnn) or

interim pay (vartpenger)

2.2 Coverage

Parental benefit for a birth can be paid at the rate of 80% for 59 weeks or 100% for 49 weeks; in the case of
adoption the rates apply for 56 and 46 weeks, respectively. The parents must choose the same coverage. If
only the father is entitled to parental benefit, the rates apply for 50 weeks and 40 weeks, respectively. The
coverage chosen cannot be changed and will apply for the entire benefit period, including the paternal quota.
100% coverage results in slightly higher total benefit than 80% coverage.
80 per cent

I choose

100 per cent

3. Birth
When is the estimated date of delivery (due date)?
(only to be completed by the mother)

day

month

year

(Confirmation of the due date

after the end of the 26th week of
pregnancy must be enclosed.)

How many children are you expecting?

When did the birth take place?

day

month

year

How many children were born?

4. Adoption
Date of assuming care:
day

month

year

How many children under 15 years of age are being adopted?

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5. Period of leave - mother

This page must only be completed by the mother and only when it is the mother who is named as the claimant on page 1.
If the claim concerns a birth, the mother can start claiming parental benefit no earlier than 12 weeks before and no later than 3
weeks before the due date. The weeks that are claimed for before the due date are deducted from the total benefit period of 59 or
49 weeks. If the baby is born before the due date, the remaining days of the 3-week period are lost. If the baby is born after the
due date, the days between the due date and the date of the birth will be deducted from the shared period. In the case of an adoption, the mother or father may claim parental benefit at the earliest from the date custody commences.

5.1 When do you want to start claiming parental benefit?

day

month

year

5.2 Maternal quota

Do you want to claim for the entire maternal quota immediately after the birth?

Yes

No

If no, write an explanation under section 7.

5.3 The mother wants to claim parental benefit for a period that is not covered
by the maternal quota (shared period)
Do you want to claim for the entire shared period immediately after the maternal quota?

Yes

No

If no, write an explanation in section 7.

If the parental benefit period is to be postponed, due to vacation or full-time work, you must submit an application for this on a
separate form prior to the desired postponement period.

5.4 The mother is applying for transfer of the paternal quota to herself

The paternal quota may only be transferred to the mother if she has sole care of the child, the father is not entitled to parental benefit or the father has been admitted to a health institution or is entirely dependent on help
with childcare because of illness. Tick below.
Sole care of the child/children

The father has been admitted to a health institution

The father is not entitled to parental

benefit

The father is entirely dependent on help with

childcare because of illness

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6. Period of leave father

This page should only be completed by the father, and only if the father is the named applicant on the first page.

6.1 The father will claim his paternal quota

When the mother and father live together and both are entitled to parental benefit, 10 (14) weeks are reserved for the father (paternal
quota). The paternal quota must, as a general rule, be claimed for as a continuous part of the shared period. The father can start
claiming for his paternal quota from the seventh week after birth at the earliest. In the case of an adoption, the father may claim for
his paternal quota at any time during the period. If the father does not want to claim for his paternal quota as a continuous part of the
shared parental benefit period or immediately after the shared period, the father must apply for a postponement using a special form.
The father must apply for a postponement no later than the last day of the shared period in order not to lose paternal quota days.

State for which period(s) the father will be claiming for his paternal quota.
Paternal quota start date
day

month

year

Paternal quota end date

day

month

year

6.2 The father is to have parental benefit that is not paternal (shared period)
If the father is to have parental benefit beyond the paternal quota, or if it is only the father who is entitled to parental benefit,
there are requirements governing the status of the mother. Tick to show the mothers status:
1.

The mother is receiving disability pension

(ufrepensjon)

2.

The mother is in work

3.

The mother is in full-time education/training

4.

The mother is in education/training in combination

with work, totalling 100 per cent

5.

The mother is participating in a qualification

programme for people with significantly reduced
work and earning capacity

6.

The mother is participating in an introduction programme for recently arrived immigrants in accordance with
chapter 2 of the Introduction Act

7.

The mother has an illness or injury that renders her entirely dependent on help with childcare

8.

The mother has been admitted to a health institution

9.

The father is to take extra weeks as a result of a multiple

birth or adoption of more than one child

State for which period(s) of the shared period the father will be claiming parental benefit.

Shared period start date

day

month

year

Shared period end date

day

month

State the reason:

year

6.3 The father has sole care of the child

If the father has sole care of the child, he may draw parental benefit at the earliest from the day he assumes care of
the child. In such cases the mother is not entitled to parental benefit once the father has assumed care.
State for which period(s) the father will be claiming parental benefit.

Parental benefit start date

day

month

year

Parental benefit end date

day

month

year

6.4 Father applies to transfer the maternal quota to him

The maternal quota may only be transferred to the father if he is solely responsible for the care of the child, the
mother is not entitled to parental benefit, the mother has been admitted to a health institution, or the mother, due to
illness, is completely dependent on help to care for the child. Tick the relevant alternative below:
Sole responsibility for the care of the child(ren)

The mother is not entitled to parental benefit

The mother has been admitted to a health institution

The mother is, due to illness, completely

dependent on help to care for the child(ren)

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7. Additional information on the applicant, The applicant may use this field if there is something not covered by the form which he/she considers NAV should be aware of. Details of the other parents benefits
should be stated in the application form for the other parent and not here as additional information.

Norwegian national identity number

8. The other parents name

(fdselsnummer) (11 digits)

9. The other parents address

Street/road
Post code
Town

10. Confirmation from the other parent

I confirm that the other parent has been informed of the periods for which I have claimed parental benefit.
Yes

No

If not, state the reason:

11. Bank account number

Your bank account number will be notified to NAV by the Norwegian Tax Administration. If you wish to see
which bank account number we are using, or to amend it, go to www.nav.no. Search for bank account number.

12. Declaration
I have read and understood the terms and conditions for receiving parental benefit.
I am aware that NAV may obtain any information necessary to process
this application.
I am aware that if I provide insufficient or incorrect information, I may be
required to repay benefit received in error and/or be liable to prosecution.

Date

Signature of applicant

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