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Get the free Families First Coronavirus Response Act (FFCRA or Act) Leave Application FormDCTU, L...

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City of PortlandDCTU, LL483 & PROTEC17 represented employees only FF CRA Emergency Paid Sick Leave & Expanded FMLA Application New RequestRevision / ExtensionEmployee Information (Type or Print) Name:
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Individuals and families who have been affected by the coronavirus pandemic, particularly those who have suffered financial challenges or health-related issues, may need to fill out the families first coronavirus response form.
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Families first coronavirus response refers to the emergency paid sick leave and expanded family and medical leave benefits provided to employees affected by COVID-19.
Employers with fewer than 500 employees are required to provide families first coronavirus response benefits.
Employers can fill out the families first coronavirus response form online or through their payroll or HR software.
The purpose of families first coronavirus response is to provide paid leave to employees affected by COVID-19, ensuring they can stay home and prevent the spread of the virus.
Employers must report the employee's name, dates of leave taken, reason for leave, and documentation supporting the leave request.
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