Fmla leave printable forms
[DOCX File]Request for Expanded FMLA Leave (Coronavirus)
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Request for Expanded FMLA Leave Form (COVID-19). To request expanded FMLA leave as provided under the Families First Coronavirus Response Act and the Expanded Family and Medical Leave Policy, please complete the following request form and submit to your human resources department as soon as possible before leave …
FMLA ACTION CHECKLIST - Human Resources
form two weeks before the FMLA Leave is scheduled to expire, along with a “Fitness for Duty to Return from Leave Certification” (FMLA 7) form, if the FMLA Leave has been for the employee’s own serious health condition, and another “Employee Request for Family and Medical Leave…
[DOCX File]FMLA COVID-19 Request Form - FINAL (03697882).DOCX
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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 …
[DOC File]LEAVE REQUEST FORM Furlough
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Paid Leave Vacation Sick Leave Comp Time (Hourly employees only) Other: Specify: Unpaid Leave Short Term Disability Long Term Disability Furlough (No Pay) This form is NOT INTENDED to be used for any leave that qualifies for or that is designated as Family or Medical Leave under the Family & Medical Leave Act …
[DOC File]Family and Medical Leave Return to Work Form
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Family and Medical Leave Return to Work Form Subject: Family and Medical Leave Return to Work Form Author: DBM Keywords: Family and Medical Leave Return to Work Form Last modified by: Carole Wollenweber Created Date: 2/19/2013 1:46:00 PM Company: State of Maryland Other titles: Family and Medical Leave …
[DOCX File]EMERGENCY PAID SICK LEAVE REQUEST FORM FOR COVID …
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EMERGENCY PAID SICK LEAVE REQUEST FORM FOR COVID-19-RELATED LEAVE. Effective for requests made on or after April 1, 2020 through December 31, 2020. Date: Employee. ID: Name (please print): Employee. Title/Position: Employee. Supervisor: I am unable to work, including engaging in telework and would like to request emergency paid sick leave …
[DOCX File]Washington, D.C.
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Your agency FMLA Coordinator must sign below acknowledging your request for Family and Medical Leave. Their signature does not constitute an approval of this application. By signing below, your agency FMLA Coordinator agrees to send you notifications regarding your application and eligibility for leave …
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