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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: 8/31/2021SECTION
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How to fill out certification of qualifying exigency

01
To fill out a certification of qualifying exigency, follow these steps:
02
Begin by providing your personal information such as your name, address, contact number, and email address.
03
Specify the name of the employee who requires the qualifying exigency leave.
04
Clearly state the relationship between the employee and the individual requesting the leave.
05
Indicate the date and time the qualifying exigency began and when it is expected to end.
06
Explain the nature of the qualifying exigency and how it necessitates the employee's presence.
07
Attach any relevant supporting documents or evidence to validate the need for the leave.
08
Sign and date the certification.
09
Submit the completed certification to the appropriate authority or department.

Who needs certification of qualifying exigency?

01
A certification of qualifying exigency is needed by employees who have a qualifying exigency due to the active military duty of a family member. This includes spouses, children, parents, or next of kin of service members who are on covered duty or have been notified of an impending call or order to covered active duty.
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Certification of qualifying exigency is a document that allows eligible employees to take leave for specific qualifying events related to a family member's military service.
Employees who wish to take leave under the Family and Medical Leave Act (FMLA) for qualifying exigencies related to a family member's military service are required to file it.
To fill out the certification, provide your personal information, the service member's information, details of the qualifying exigency, and any supporting documentation required by your employer.
The purpose of the certification is to provide verification of the employee's need for leave due to a qualifying exigency resulting from a family member's military duty.
The report must include the employee's details, the relationship to the service member, the reason for the leave, and the dates and duration of the requested leave.
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