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CERTIFICATION OF HEALTH CARE PROVIDER FOR EMPLOYEES SERIOUS HEALTH CONDITION (FAMILY AND MEDICAL LEAVE ACT) Adapted from Form WH380E Revised May 2015Section I: For Completion by the EMPLOYER Name
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How to fill out employer name and contact

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To fill out the employer name and contact, follow these steps:
02
Locate the fields designated for employer name and contact information on the form.
03
Input the full name of your employer in the employer name field.
04
Provide the contact details of your employer, such as their phone number or email address, in the contact field.
05
Double-check the accuracy of the provided information before submitting the form.

Who needs employer name and contact?

01
Various individuals or entities may require the employer name and contact information. These may include:
02
- Job applicants: When applying for a job, individuals may need to provide the name and contact information of their current or previous employers.
03
- Employees: Some employment-related documents, like contracts or insurance forms, may ask for the employer's name and contact details.
04
- Government agencies: For tax and legal purposes, government authorities may require a person or organization's employer name and contact information.
05
- Researchers or analysts: Studying workforce trends or conducting surveys often involves collecting employer data, which includes the name and contact details.
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The employer name and contact refers to the official name of the business or organization and the contact information, such as phone number and email address, that is used for communication regarding employment-related matters.
Employers who are required to submit reports and documents related to payroll, taxes, and employee information must file the employer name and contact.
To fill out employer name and contact, provide the official name of the employer as registered, along with the primary contact person's name, phone number, email address, and physical address.
The purpose of employer name and contact is to ensure clear communication between the employer and regulatory agencies, as well as to provide accurate information for tax reporting and compliance.
The information that must be reported includes the employer's legal name, contact person, phone number, email address, and mailing address.
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