Get the free WH-384 - dmna ny

Certification of Qualifying Exigency For Military Family Leave (Family and Medical Leave Act)U.S. Department of Labor Wage and Hour Division OMB Control Number: 12350003 Expires: 3/31/2015SECTION

How to fill out wh-384 - dmna ny

How to fill out wh-384

1. To fill out wh-384 form, follow these steps:
2. Start by entering the current date in the 'Date' section of the form.
3. Provide your name, job title, office phone number, and email address in the 'Employee Information' section.
4. In the 'Check One' section, indicate whether you are requesting leave under the Family and Medical Leave Act (FMLA) or under the Families First Coronavirus Response Act (FFCRA).
5. If you are requesting FMLA leave, provide the start and end dates of your anticipated leave period in the 'Dates of Leave' section.
6. In the 'FMLA Qualifying Reason' section, check the appropriate box that corresponds with the reason for your leave.
7. If you are requesting FFCRA leave, indicate the reason for your leave by checking the appropriate box in the 'FFCRA Qualifying Reason' section.
8. In the 'Additional Information' section, provide any extra details or clarifications about your leave request.
9. Sign and date the form in the designated area at the bottom.
10. Finally, submit the completed form to the appropriate authority for processing.
11. Note: Make sure to consult your employer's policies or HR department for specific instructions in case any additional steps are required.

Who needs wh-384?

1. wh-384 form is needed by employees who are requesting leave under the Family and Medical Leave Act (FMLA) or under the Families First Coronavirus Response Act (FFCRA).
2. This form is used to formally request and document the need for leave related to specific qualifying reasons under these acts.
3. It provides necessary information to employers and ensures compliance with the legal requirements for leave entitlement and protections.
4. Employees who meet the eligibility criteria for FMLA or FFCRA leave should use this form to initiate the leave request process and communicate their intentions to their employer.

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What is wh-384?

Wh-384 is a Certification of Health Care Provider form used for employees to request leave under the Family and Medical Leave Act (FMLA).

Who is required to file wh-384?

Both the employee requesting leave and the health care provider must complete and file wh-384.

How to fill out wh-384?

To fill out wh-384, the employee must provide their information, the reason for the leave, and the health care provider must certify the medical condition.

What is the purpose of wh-384?

The purpose of wh-384 is to verify the need for leave under the FMLA due to a serious health condition.

What information must be reported on wh-384?

Wh-384 requires information about the employee's condition, the anticipated duration of the leave, and the certification by the health care provider.