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Cagney Life Insurance Company of New York Life Insurance Company of North AmericaIntermittent Leave of Absence Time Tracking Report Name:Employee ID: (if known)Employer Name: When you're taking approved
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How to fill out intermittent leave of absence

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How to fill out intermittent leave of absence

01
Step 1: Access the company's HR system or visit the HR department.
02
Step 2: Obtain the intermittent leave of absence form or request it from the HR personnel.
03
Step 3: Fill out the form with your personal information such as name, employee number, and contact details.
04
Step 4: Specify the start and end dates of your intermittent leave periods. You may need to provide medical documentation if it's for medical reasons.
05
Step 5: Indicate the reason for the intermittent leave, whether it's for medical treatment, caregiving, or other approved reasons.
06
Step 6: Include any additional information or special instructions if required.
07
Step 7: Review the completed form for accuracy and completeness.
08
Step 8: Submit the form to the HR department or follow the designated submission process.
09
Step 9: Keep a copy of the filled-out form for your records.
10
Step 10: Wait for confirmation or further instructions from the HR department regarding your intermittent leave of absence.

Who needs intermittent leave of absence?

01
Employees who experience recurring medical conditions and require time off for treatment.
02
Employees who are caregivers and need to take intermittent leave to care for a family member with a serious health condition.
03
Employees who have personal or family emergencies that necessitate intermittent time off.
04
Employees who are pregnant and need to take time off for prenatal care or related conditions.
05
Employees who qualify for intermittent leave under the Family and Medical Leave Act (FMLA) or other applicable leave policies.
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Intermittent leave of absence is a type of leave that allows employees to take time off work in separate blocks of time.
Employees who are eligible for intermittent leave of absence under the Family and Medical Leave Act (FMLA) are required to file for it.
Employees can fill out intermittent leave of absence request forms provided by their employer or HR department.
The purpose of intermittent leave of absence is to allow employees to take time off work for medical reasons or to care for a family member.
Employees must report the dates they will be taking leave, the reason for their leave, and any documentation required by their employer.
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