North Carolina Family and Medical Leave Request Form

State:
Multi-State
Control #:
US-266EM
Format:
Word; 
Rich Text
Instant download

Description

An employee may use this form to request leave under the FMLA.
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  • Preview Family and Medical Leave Request Form
  • Preview Family and Medical Leave Request Form
  • Preview Family and Medical Leave Request Form

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FAQ

Employees are eligible for FMLA leave if:they have worked for the company for at least a year.they worked at least 1,250 hours during the previous year, and.they work at a location with at least 50 employees within a 75-mile radius.

To apply for FMLA, the employee must take an FMLA Medical Certification Form to their health care provider. This form ensures that the employee's or family member's applicable health condition is valid. After receiving the form, the employee must return it within 15 calendar days.

This Act provides reasonable unpaid (1) Family and medical leave for the birth of a child and to care for the newborn child; for the placement of a child with the employee for adoption or foster care; for the care of a child, spouse or parent who has a serious health condition; for the employee's own serious health

The Family and Medical Leave Act (FMLA) entitles eligible employees to take up to 12 workweeks of unpaid, job-protected leave in a 12-month period for a qualifying exigency arising out of the foreign deployment of the employee's spouse, son, daughter, or parent.

Employees are eligible for FMLA leave if:they have worked for the company for at least a year.they worked at least 1,250 hours during the previous year, and.they work at a location with at least 50 employees within a 75-mile radius.

FMLA leave is unpaid, but employees may be allowed (or required) to use their accrued paid leave during FMLA leave. When an employee's FMLA leave ends, the employee is entitled to be reinstated to the same or an equivalent position, with a few exceptions.

In order to be eligible to take leave under the FMLA, an employee must (1) work for a covered employer, (2) work 1,250 hours during the 12 months prior to the start of leave, (3) work at a location where 50 or more employees work at that location or within 75 miles of it, and (4) have worked for the employer for 12

The Family and Medical Leave Act (FMLA) entitles eligible employees to take up to 12 workweeks of unpaid, job-protected leave in a 12-month period for a qualifying exigency arising out of the foreign deployment of the employee's spouse, son, daughter, or parent.

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North Carolina Family and Medical Leave Request Form