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Certification of Qualifying Exigency for Military Family Leave (Family and Medical Leave Act) SECTION I: For Completion by the Supervisor INSTRUCTIONS to the Supervisor: The Family and Medical Leave
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How to fill out certification of qualifying exigency

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How to fill out certification of qualifying exigency:

01
Start by gathering all the necessary information and documents required for the certification. This may include the employee's name, relationship to the military member, date of deployment, and the type of qualifying exigency being claimed.
02
Begin filling out the form by providing the employee's personal details, such as their name, address, and contact information.
03
Next, indicate the name of the military member and their branch of service.
04
Specify the start and end dates of the military member's covered active duty or call to covered active duty.
05
Determine the type of qualifying exigency being claimed and provide a brief description or explanation of the circumstances.
06
If applicable, provide any additional supporting documentation or evidence to substantiate the claim. This may include copies of orders, medical certification, or other relevant paperwork.
07
Review the completed form for accuracy and completeness, ensuring that all required fields have been filled out correctly.
08
Sign and date the certification of qualifying exigency form, attesting to the truthfulness and accuracy of the provided information.
09
Submit the completed form to the appropriate party or department as instructed.

Who needs certification of qualifying exigency?

01
Employees who require time off from work to address certain qualifying exigencies related to the deployment of a military member.
02
These qualifying exigencies may include issues such as arranging for alternative childcare, attending certain military events or ceremonies, making financial or legal arrangements, or addressing certain medical or psychological needs.
03
The employee must meet certain eligibility criteria and the certification of qualifying exigency form serves as a means to request and document the need for this time off.
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Certification of qualifying exigency is a form that allows eligible employees to request leave under the Family and Medical Leave Act (FMLA) for qualifying exigencies related to a covered military member's active duty.
Employees who are eligible for FMLA leave and need to take time off for qualifying exigencies related to a covered military member's active duty are required to file certification of qualifying exigency.
Employees can obtain the form from their employer or the Department of Labor website, then fill out the required information, including details about the qualifying exigency and their relationship to the covered military member.
The purpose of certification of qualifying exigency is to provide documentation to support an eligible employee's request for FMLA leave for qualifying exigencies related to a covered military member's active duty.
The certification must include details about the specific qualifying exigency, the relationship to the covered military member, and any other relevant information requested on the form.
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