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Get CA DPA 754 2009

Mily Rights Act (CFRA) Part A: For Completion by the person responsible for administering the leave program in your department who will be the Department Contact. Instructions: Complete Section I before giving this form to the employee. Employee’s Name (Last, First, Middle): Last Day Worked: Employee’s Classification: Employee’s Work Unit: Department Contact: Department Contact Phone: Attach a copy of the employee’s job description and the essential job functions of the employee’s .

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