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Family and Medical Leave Act Request Form HRBEN028 Section 1 Information and Instructions The purpose of this form is to request a leave of absence under the Family and Medical Leave Act (FMLA). DO.

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How to fill out the MTA HR-BEN-028 online

This guide provides comprehensive instructions for completing the MTA HR-BEN-028 form, which is essential for requesting leave under the Family and Medical Leave Act. Following these steps will ensure that your application is completed accurately and submitted promptly.

Follow the steps to successfully complete the MTA HR-BEN-028 form.

  1. Click the ‘Get Form’ button to access the MTA HR-BEN-028 form and open it in your preferred online editor.
  2. In Section 2, fill out your employee information including your BSC ID, name, agency ID, job title, and contact details. Make sure to include a valid email address for communication purposes.
  3. Move to Section 3 and select the reason for your leave by checking only one box that corresponds to your situation, such as serious health condition or caring for a family member.
  4. In Section 4, enter the start and end dates for your requested leave. Ensure that these dates comply with the notice requirements outlined in the form.
  5. Proceed to Section 5 to specify the type of leave you are requesting: intermittent, reduced schedule, or continuous. If you select intermittent or reduced schedule, provide the details of your proposed schedule.
  6. In Section 6, authorize your request by signing and dating the form. Confirm that all the information you provided is accurate to the best of your knowledge.
  7. Send the completed form to your designated agency contact as detailed in Section V. Ensure the submission is made 30 days prior to the start of your leave or as soon as possible.
  8. Before finalizing, review the form for any errors. Once satisfied, you can save your changes, download a copy for your records, print the form, or share it as required.

Complete your MTA HR-BEN-028 form online today to ensure your leave request is processed promptly.

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MTA HR-BEN-028
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