This form is an Employment Application. The form provides that applications are considered without regard to race, color, religion, or veteran status.
Employee Request Form For Fmla Leave In Harris
Category:
State:
Multi-State
County:
Harris
Control #:
US-00413
Format:
Word;
Rich Text
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There are five DOL optional-use FMLA certification forms. If they do not request a certification, move on to step 4.Step 3: Provide a completed certification to your employer. This is a sample form for employees to request time off under the Family and Medical Leave Act. Note: FMLA provides up to 26 work weeks for this type of leave. If you have difficulty in obtaining the Paid Family Leave forms or need help in completing these forms, please contact the PFL Helpline at . Download and save the PDF file to your computer before filling out. To have medical records sent to us or to request your medical records, please fill out the Medical Release Form and fax to .