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APPLICATION FOR FAMILY AND MEDICAL LEAVE Original Application Extension/Change Last Name First Name (printed) Date of Hire Social Security Number Dept./Bldg. Employee must be employed with the Valley
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How to fill out family medical leave formcurrentdoc

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How to fill out family medical leave formcurrentdoc?

01
Start by obtaining the family medical leave formcurrentdoc from your employer or Human Resources department.
02
Familiarize yourself with the instructions provided on the form. Read through them carefully to understand the requirements and ensure you provide all the necessary information.
03
Begin by providing your personal details, such as your full name, contact information, and employee identification number, if applicable.
04
Specify the reason for your leave by selecting the appropriate category, such as your own serious health condition, caring for a family member, or bonding with a new child.
05
Indicate the start and end dates of your leave, making sure to include any requested intermittent leave if applicable.
06
If you have any medical certifications or documentation supporting your need for leave, attach them to the form as instructed.
07
Review the completed form for accuracy, ensuring all sections are filled out correctly and legibly.
08
Sign and date the form, indicating your understanding and agreement to comply with the terms and conditions of the family medical leave.
09
Submit the completed form to your employer or Human Resources department within the specified time frame.
10
Keep a copy of the form for your records.

Who needs family medical leave formcurrentdoc?

01
Employees who need to take a leave of absence due to their own serious health condition.
02
Employees who need to care for a family member with a serious health condition.
03
Employees who need to bond with a new child through birth, adoption, or foster care placement.
04
Employees who are eligible for leave under the Family and Medical Leave Act (FMLA) or other applicable state or federal laws.
05
Employees who have been instructed by their employer or Human Resources department to complete the family medical leave formcurrentdoc for leave approval and documentation purposes.
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Family Medical Leave Formcurrentdoc is a document that employees can use to request time off from work for medical reasons.
Employees who need to take time off from work for medical reasons are required to file Family Medical Leave Formcurrentdoc.
To fill out Family Medical Leave Formcurrentdoc, employees need to provide their personal information, details of their medical condition, and the duration of time off needed.
The purpose of Family Medical Leave Formcurrentdoc is to allow employees to request time off from work for medical reasons while protecting their job and benefits.
Family Medical Leave Formcurrentdoc must include details of the employee's medical condition, expected duration of time off, and any supporting documentation from a healthcare provider.
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