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U.S. DEPARTMENT OF LibreOffice of Workers Compensation ProgramsDivision of Federal Employees\' Compensation OMB Number: 12150206 Expiration Date: May 31, 2010Official Notice of Employees Death for
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OMB Control Number 1215-0206 is assigned to the Department of Labor for the purpose of collecting information on the certification of health care provider on Family and Medical Leave Act (FMLA) forms.
Employers covered by the FMLA are required to file OMB Control Number 1215-0206 when their employees request leave for qualifying reasons.
Employers must complete and provide the FMLA forms to employees requesting leave. The forms require information about the health care provider certifying the need for leave.
The purpose of OMB Control Number 1215-0206 is to ensure that employees are eligible for FMLA leave by verifying their need for time off due to a serious health condition.
Information such as the health care provider's information, details of the serious health condition, and the expected duration of the leave must be reported on OMB Control Number 1215-0206.
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