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CLEAR FORMIDABLE NATIONAL GUARD FAMILY MEDICAL LEAVE ACT (FMLA) LEAVE REQUEST FORM PART A: COMPLETED BY REQUESTING EMPLOYEE, THEN SUBMIT TO SUPERVISOR Employee Name: Employee Personal Phone Number:

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How to fill out fmla leave request form

01

Obtain a copy of the FMLA leave request form from your employer or the HR department.

02

Fill out your personal information including name, employee ID, department, and contact information.

03

Specify the reason for requesting FMLA leave such as a serious medical condition for yourself or a family member.

04

Indicate the dates for which you will need FMLA leave and if the leave will be continuous or intermittent.

05

Provide any supporting documentation required by your employer such as a doctor's note or medical certification.

06

Sign and date the form before submitting it to the HR department for review and approval.

Who needs fmla leave request form?

01

Employees who are eligible for FMLA leave and need to take time off work for a qualifying reason such as their own serious health condition, to care for a family member with a serious health condition, or for the birth or adoption of a child.

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What is fmla leave request form?

FMLA leave request form is a form that employees use to request leave under the Family and Medical Leave Act.

Who is required to file fmla leave request form?

Employees who need to take leave under the Family and Medical Leave Act are required to file FMLA leave request form.

How to fill out fmla leave request form?

To fill out FMLA leave request form, employees need to provide information about the reason for their leave, the duration of the leave, and any supporting documentation.

What is the purpose of fmla leave request form?

The purpose of FMLA leave request form is to notify employers of the employee's need for leave under the Family and Medical Leave Act.

What information must be reported on fmla leave request form?

Information that must be reported on FMLA leave request form includes the reason for the leave, the expected duration of the leave, and any relevant medical documentation.

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