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Certification of Qualifying Exigency for Military Family Leave (Family and Medical Leave Act) Section I: For Completion by the Employer INSTRUCTIONS to the Employer: The Family and Medical Leave Act
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How to fill out certification of qualifying exigency

01
To fill out the certification of qualifying exigency, follow these steps:
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Start by entering your personal information, such as your full name, contact information, and employee number.
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Next, provide details about the qualifying exigency for which you are seeking leave. This may include information about the military member's active duty status, the reason for the leave, and the start and end dates of the leave.
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Indicate the relationship between you and the military member for whom you are requesting leave.
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If applicable, provide any supporting documentation that may be required, such as military orders or official documentation related to the qualifying exigency.
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Sign and date the certification form to declare that the information provided is accurate and complete.
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Submit the completed form to your employer or the relevant authority as instructed.

Who needs certification of qualifying exigency?

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A certification of qualifying exigency may be needed by employees who are covered by the Family and Medical Leave Act (FMLA) and are requesting leave for certain situations related to a military member's active duty or call to active duty status.
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This includes eligible employees who are the spouse, child, parent, or next of kin of a military member.
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The certification is required to provide proof and documentation of the qualifying exigency and support the employee's request for leave under the FMLA.
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Certification of qualifying exigency is a form that verifies an employee's need for leave under the Family and Medical Leave Act (FMLA) due to exigent circumstances related to a family member's military service.
Employees who are taking leave under the FMLA for qualifying exigencies related to a family member's military service are required to file the certification.
To fill out the certification, employees must provide information such as the name of the service member, the relationship to the employee, the facts supporting the need for leave, and other relevant details as required by the form.
The purpose of the certification is to substantiate the employee’s request for leave and to ensure that the leave taken is in compliance with FMLA provisions regarding military family leave.
The information required includes the employee's name, the service member's name, the nature of the qualifying exigency, and any relevant dates or circumstances that justify the leave.
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