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EMERGENCY FAMILY AND MEDICAL LEAVE REQUEST Employees requesting Emergency FMLA (FMLA) pursuant to the Families First Coronavirus Response Act (FF CRA) must complete this form. You must provide as
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Obtain a copy of the emergency-family-and-medical-leave-act-efmla-request-form from your HR department or online.
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Fill out your personal information, including your name, contact information, and employee ID.
03
Provide details about the reason for your request, such as a medical condition or family emergency.
04
Indicate the dates you will need to take leave and the expected duration of your absence.
05
Attach any supporting documentation, such as a doctor's note or court order, if required.
06
Review the completed form for accuracy and sign and date it before submitting it to your HR department.

Who needs emergency-family-and-medical-leave-act-efmla-request-form?

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Employees who need to take emergency family and medical leave due to a qualifying reason as defined by the Emergency Family and Medical Leave Act (EFMLA) need to fill out the EFMLA request form.
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The Emergency Family and Medical Leave Act (EFMLA) request form is a document used to request leave from work for qualified reasons related to COVID-19.
Employees who are eligible for EFMLA and need to take leave for COVID-19 related reasons are required to file the request form.
The form needs to be completed with personal information, reason for leave, duration of leave needed, and any supporting documentation.
The purpose of the form is to request and document leave taken under the Emergency Family and Medical Leave Act for COVID-19 related reasons.
The form generally requires information such as employee's name, reason for leave, duration of leave needed, and any supporting documentation as necessary.
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