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Emergency Paid Sick Leave (ESL) Request Form Employee Name: Instructions: Please use this form when requesting ESL if you are unable to work due to a qualifying reason related to COVID-19 pursuant
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How to fill out emergency paid sick leave

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How to fill out emergency paid sick leave

01
Step 1: Determine if you are eligible for emergency paid sick leave. This type of leave is available to employees who are unable to work or telework due to specific COVID-19 related reasons.
02
Step 2: Obtain the necessary documentation. You may be required to provide certain information or documentation to support your request for emergency paid sick leave.
03
Step 3: Fill out the emergency paid sick leave form. Ask your employer for the specific form or format they require for submitting your request.
04
Step 4: Provide all the required details in the form. Make sure to accurately and fully complete the form, including your personal information, reason for leave, and expected duration.
05
Step 5: Submit the form to your employer. Follow your company's procedures for submitting your request, whether it is through email, an online portal, or in-person.
06
Step 6: Await approval/notification. Your employer will review your request and inform you of the approval status or any additional steps you need to take.
07
Step 7: Follow any further instructions. If your emergency paid sick leave request is approved, your employer will provide you with guidelines on how to properly use the leave and comply with the company's policies.
08
Step 8: Keep track of your leave records. Maintain accurate records of your emergency paid sick leave usage, including dates, reasons, and any supporting documentation.
09
Step 9: Communicate with your employer. If there are any changes or updates to your leave situation, promptly inform your employer to ensure proper documentation and adherence to company policies.
10
Step 10: Return to work as scheduled. Once your emergency paid sick leave period is over and you are able to resume work, inform your employer and adhere to any return-to-work protocols they may have.
11
Step 11: Follow up with any required reporting. If your employer requires reporting or documentation after your emergency paid sick leave, make sure to provide the necessary information within the specified timeframe.

Who needs emergency paid sick leave?

01
Emergency paid sick leave is applicable to eligible employees who are unable to work or telework due to specific COVID-19 related reasons.
02
This includes individuals who are experiencing COVID-19 symptoms and seeking a medical diagnosis, are advised by a healthcare provider to self-quarantine, or are caring for an individual subject to a quarantine or isolation order.
03
Additionally, individuals who need to care for a child whose school or childcare provider is closed or unavailable due to COVID-19 may also need emergency paid sick leave.
04
It's important to refer to your company's policies and guidelines to determine who is eligible for emergency paid sick leave in your specific workplace.
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Emergency paid sick leave is a provision that allows employees to take paid time off for specified reasons related to COVID-19.
Employers with fewer than 500 employees are required to provide emergency paid sick leave to their employees.
Employees can fill out emergency paid sick leave by submitting a request to their employer with the necessary information and documentation.
The purpose of emergency paid sick leave is to provide financial assistance to employees who need to take time off work due to COVID-19 related reasons.
Employees must report their name, date of request, reason for leave, and any supporting documentation.
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