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Get Dol Wh-381 2020-2026

If you have any questions please do not hesitate to contact PAPERWORK REDUCTION ACT NOTICE AND PUBLIC BURDEN STATEMENT It is mandatory for employers to provide employees with notice of their eligibility for FMLA protection and their rights and responsibilities. Serious injury or illness. This Notice is to inform you that you Are eligible for FMLA leave See Part B below for Rights and Responsibilities Are not eligible for FMLA leave because only one reason need be checked although you may not be eligible for other reasons You have not met the FMLA s 12-month length of service requirement. Notice of Eligibility and Rights Responsibilities Family and Medical Leave Act U.S. Department of Labor Wage and Hour Division OMB Control Number 1235-0003 Expires 2/28/2015 In general to be eligible an employee must have worked for an employer for at least 12 months meet the hours of service requirement in the 12 months preceding the leave and work at a site with at least 50 employees within 75 miles.....

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How to fill out the DoL WH-381 online

The Department of Labor's Form WH-381 is an essential document for employees seeking leave under the Family and Medical Leave Act. Completing this form accurately is crucial to ensure that your rights and responsibilities are clearly established. This guide provides step-by-step instructions to help you fill out the WH-381 online with confidence.

Follow the steps to successfully complete the DoL WH-381 online.

  1. Press the ‘Get Form’ button to access the DoL WH-381 and open it in your document management tool.
  2. Enter the date of the notice in the specified field (mm/dd/yyyy). This indicates when the notice is being provided.
  3. Fill in your employer's name in the 'From' section and your name in the 'To' section. This clarifies the sender and recipient of the notice.
  4. Provide the starting date of your requested leave in the appropriate space. Make sure to check the boxes for the reason for leave — choose one that applies.
  5. Under Section I, indicate whether you are eligible for FMLA leave by checking the appropriate box. If not eligible, select the reason that applies to your situation.
  6. In Section II, check if any additional information is required for determining your absence’s qualification as FMLA leave. If needed, specify the type of certification required and include relevant dates for submission.
  7. Complete Section III to understand your rights and responsibilities under the FMLA. Make sure to read through each part to comprehend how FMLA leave functions and any employer-specific requirements.
  8. After entering all information, review the form for accuracy. Once confirmed, save your changes, download the completed form, and consider printing or sharing it as needed.

Start filling out your DoL WH-381 form online today to ensure your leave is properly managed.

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Related content

WH-381 - US Department of Labor
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WH-381 - US Department of Labor
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