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Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave under the Family and Medical Leave Act. S. Department of Labor Wage and Hour Division DO NOT SEND COMPLETED FORM
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How to fill out family medical leave act
How to fill out wh-384 pdf
01
Download the WH-384 form from the relevant website.
02
Fill out the employer information section including name, address, and EIN.
03
Provide details of the employee being covered by the form including name, occupation, and hours worked.
04
Indicate the leave request type and relevant dates.
05
Sign and date the form as the employer.
06
Distribute the completed form to the appropriate parties as necessary.
Who needs wh-384 pdf?
01
Employers who are required to provide leave under the Family and Medical Leave Act (FMLA) need WH-384 form.
02
Employees who are requesting leave under FMLA also need WH-384 form to be filled out by their employers.
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What is wh-384 pdf?
wh-384 pdf is a form used to request the certification of a serious health condition of the employee or the employee's family member under the Family and Medical Leave Act (FMLA).
Who is required to file wh-384 pdf?
Employers are required to provide the wh-384 pdf form to employees requesting FMLA leave for a serious health condition.
How to fill out wh-384 pdf?
To fill out wh-384 pdf, the employee must provide personal information, details of the serious health condition, and the healthcare provider's information.
What is the purpose of wh-384 pdf?
The purpose of wh-384 pdf is to certify the need for FMLA leave due to a serious health condition.
What information must be reported on wh-384 pdf?
Information such as the employee's name, date of birth, description of the serious health condition, and the healthcare provider's contact information must be reported on wh-384 pdf.
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