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EMERGENCY PAID SICK LEAVE ACT & FM EXPANSION LEAVE REQUEST AND CERTIFICATION OF NEED FOR LEAVE (effective 4/1/202012/31/2020) Please complete this form to the best extent possible. Upon submission,

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How to fill out emergency paid sick leave

01

Determine if you are eligible for emergency paid sick leave.

02

Submit a request to your employer for emergency paid sick leave.

03

Provide documentation, if required, to support your request for emergency paid sick leave.

04

Fill out any necessary forms provided by your employer.

05

Follow any additional instructions or requirements set forth by your employer.

Who needs emergency paid sick leave?

01

Employees who are unable to work due to COVID-19 related reasons.

02

Employees who are caring for someone who is sick due to COVID-19.

03

Employees who are subject to a quarantine or isolation order related to COVID-19.

04

Employees who are experiencing COVID-19 symptoms and seeking a medical diagnosis.

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What is emergency paid sick leave?

Emergency paid sick leave is a provision that allows employees to take paid time off for specified reasons related to COVID-19.

Who is required to file emergency paid sick leave?

Employees who are unable to work or telework due to qualifying reasons related to COVID-19 may be eligible to file for emergency paid sick leave.

How to fill out emergency paid sick leave?

Employees can request emergency paid sick leave by submitting a request to their employer with necessary documentation.

What is the purpose of emergency paid sick leave?

The purpose of emergency paid sick leave is to provide employees with paid time off to address COVID-19 related issues and prevent the spread of the virus.

What information must be reported on emergency paid sick leave?

Employees must provide information on the reason for their leave, the dates they are requesting leave, and any relevant documentation supporting their request.

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