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Certification of Qualifying Exigency For Military Family Leave (Family and Medical Leave Act) OMB Control Number: 12350003 Expires: 12/31/2018SECTION I: For Completion by the EMPLOYER INSTRUCTIONS
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How to fill out family and medical leave

01
Obtain the necessary forms from your employer or HR department.
02
Fill out the forms completely and accurately, providing all requested information.
03
Attach any relevant documentation, such as a doctor's note or medical records, to support your request.
04
Submit the completed forms and documentation to your employer within the specified timeframe.
05
Await approval or denial of your request for family and medical leave.

Who needs family and medical leave?

01
Employees who need to take time off work to care for a newborn or newly adopted child.
02
Employees who need to care for a family member with a serious health condition.
03
Employees who need to take time off work due to their own serious health condition.
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Family and medical leave is a job-protected leave that allows eligible employees to take time off for personal medical reasons or to care for a family member.
Employees who meet certain eligibility requirements and need to take time off for qualifying reasons are required to file for family and medical leave.
To fill out family and medical leave, employees must typically submit a request to their employer along with any required documentation supporting the need for leave.
The purpose of family and medical leave is to allow employees to balance their work and personal responsibilities without risking their job security.
Information such as the reason for the leave, anticipated duration, and any supporting documentation may need to be reported on family and medical leave.
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