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JUDICIARY FOR THE STATE OF MARYLAND REQUEST FOR FAMILY/MEDICAL LEAVE Page 1 of 2 TO BE COMPLETED BY EMPLOYEE 1. 2. Name: Title: Home address: Department: Jurisdiction: Home phone number: Work phone
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What is request for fmla form?
The request for FMLA (Family and Medical Leave Act) form is a document used by employees to formally request leave under the FMLA, a federal law that provides eligible employees with job-protected leave for specific family and medical reasons.
Who is required to file request for fmla form?
Any eligible employee who wishes to take leave under the FMLA is required to file a request for FMLA form.
How to fill out request for fmla form?
To fill out the request for FMLA form, employees need to provide their personal information, specify the reason for the requested leave, provide documentation supporting the need for leave (such as medical certificates), and indicate the duration and start date of the requested leave.
What is the purpose of request for fmla form?
The purpose of the request for FMLA form is to officially notify the employer of an employee's intent to take FMLA leave and to provide the necessary information for the employer to determine if the leave qualifies under the FMLA.
What information must be reported on request for fmla form?
The request for FMLA form typically requires the employee to provide their personal information, the reason for the requested leave, supporting documentation (such as medical certificates), and the duration and start date of the requested leave.
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