Get the free fmla designation notice - City of Milwaukee - city milwaukee
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Department of Employee Relations r. 03.31.17 FMLA DESIGNATION NOTICE Department FMLA Leave Administrator to complete appropriate sections. EMPLOYEE INFORMATION Name: People Soft ID #: Dates: 1. Your
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How to fill out fmla designation notice
How to fill out fmla designation notice
01
Read the FMLA designation notice carefully to understand the requirements and instructions.
02
Complete the employee information section, providing your name, job title, and employee ID number.
03
Enter the name and contact information of your healthcare provider who can certify your need for FMLA leave.
04
Specify the type of leave you are requesting (continuous, intermittent, or reduced schedule) and provide the start and end dates if applicable.
05
Include any additional documentation supporting your need for FMLA leave, such as medical records or treatment plans.
06
Sign and date the FMLA designation notice to acknowledge your understanding and agreement with the information provided.
07
Submit the completed FMLA designation notice to your employer's HR department or designated FMLA coordinator.
08
Keep a copy of the filled-out FMLA designation notice for your records.
Who needs fmla designation notice?
01
Employees who require leave for their own serious health condition.
02
Employees who need to care for a family member with a serious health condition.
03
Parents who need to bond with a newborn, newly adopted, or newly placed foster child.
04
Employees with a qualifying exigency arising from a covered military member's active duty or call to active duty.
05
Family members of injured servicemembers who need to provide care or support.
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