Get Union Pacific Road Form 16873 2013-2025

Filling out the Union Pacific Road Form 16873 online is a crucial step for employees seeking Family and Medical Leave Act (FMLA) leave. This guide will help you navigate through each section of the form with clarity and ease.

Follow the steps to complete the Union Pacific Road Form 16873 online.

1. Press the ‘Get Form’ button to access the document and open it in your preferred online editor.
2. Begin by entering your name as the employee in the designated field.
3. Input your Employee ID number to ensure accurate identification.
4. Fill in the Service Unit where you work, ensuring it matches your employment details.
5. Provide your Job Title to reflect your current position.
6. Include the name of your Supervisor in the appropriate section.
7. Indicate whether you are submitting a Non-Agreement request.
8. Date your request at the top of the form to capture when it was completed.
9. Specify the date you informed your employer about your need for FMLA leave, along with the start and end dates of your requested leave.
10. Select the reason for your leave from the provided options, including the birth of a child, personal health condition, or to care for a family member.
11. For personal health leave, include the details about the individual with the serious health condition.
12. If applicable, fill in information related to military leave or qualifying exigency.
13. Check the eligibility confirmation box regarding total service and hours worked.
14. Outline any required documentation that needs to be returned along with the form.
15. Once all sections are completed, save your changes and prepare to download, print, or share the form as necessary.

Complete your Union Pacific Road Form 16873 online today to ensure a smooth leave process.