Family medical leave application form

    • [DOC File]Family and Medical Leave Request Form

      https://info.5y1.org/family-medical-leave-application-form_1_9ba685.html

      For medical absences, including reduced schedule or incapacity of greater than 5 days, or other LOA’s of any duration. this form should be completed and submitted to Human Resources at least 30 days before the leave is to commence, if the need for leave is foreseeable.

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    • [DOC File]Application for Family or Medical Leave

      https://info.5y1.org/family-medical-leave-application-form_1_19f2d5.html

      1 Here and elsewhere on this form, the information sought relates only to the condition for which the employee is taking FMLA leave. 2 “Incapacity,” for purpose of FMLA, is defined to mean inability to work, attend school or perform other regular daily activities due to the serious health condition, treatment therefor, or recovery therefrom.

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    • [DOC File]Application for Family or Medical Leave

      https://info.5y1.org/family-medical-leave-application-form_1_8e5b36.html

      Application for Family or Medical Leave Author: Puyallup School District Last modified by: Pyles, Dawn M. Created Date: 8/13/2018 6:19:00 PM Company: Puyallup School District Other titles: Application for Family or Medical Leave

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    • [DOCX File]FMLA COVID-19 Request Form - FINAL (03697882).DOCX

      https://info.5y1.org/family-medical-leave-application-form_1_d9e5da.html

      FMLA ELIGIBILITY SUPPLEMENTAL FORM FOR COVID-19-RELATED LEAVE. Effective for such requests made on or after April 1, 2020 through December 31, 2020. The Families First Coronavirus Response Act, enacted on March 18, 2020, increases employee access to Family and Medical Leave Act (FMLA) leave to cover leave requests related to the COVID-19 pandemic.

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    • [DOC File]Leave Application Form

      https://info.5y1.org/family-medical-leave-application-form_1_bda35d.html

      **Supervisor’s approval not necessary, however s/m must inform supervisor and leave monitor when on sick leave. For “certified” sick leave, medical certification should be submitted to Leave Monitor upon return. ***Related Overtime Request Form signed by supervisor should be attached.

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    • [DOC File]Family and Medical Leave Application Request

      https://info.5y1.org/family-medical-leave-application-form_1_989470.html

      FAMILY AND MEDICAL LEAVE APPLICATION REQUEST (See ADS Chapter 481 for detailed information) 1. Name. 2. Grade. 3. Position Title. 4. Series/Skill code. 5. Mission/Office Symbol. 6. Basic Pay Rate. 7. Reason for Application for Leave (check one of the following): a. Care for a newborn or newly adopted child (including foster children) * b.

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    • [DOCX File]Washington, D.C.

      https://info.5y1.org/family-medical-leave-application-form_1_7b31fd.html

      Family Medical Leave Application Form | DCSF No. FML-01 (Rev 07/2020)Page 1 of 3. Before you begin your application, to the extent possible, please ensure that you have the required supporting documents completed and readily available for submission. A list of the required documents is provided at the end of this application.

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