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Get Form 9611 (rev. 6-2014). Application For Leave Under The Family And Medical Leave Act

5. Series 6. Grade Military Family FMLA (26-week) 7. Organization/Function 8. Reason for request: (check all that apply) a. (12-week) Birth of a son or daughter and care of such child. 5 CFR 630.1203a(l) b. (12-week) Placement of son or daughter with you for adoption or foster care. 5 CFR 630.1203a(2) c. (12-week) Care of your spouse, son, daughter, or parent who has a serious health condition. 5 CFR 630.1203a(3) d. (12-week) A personal serious health condition which prohibits.

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