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Get LSU AgCenter FMLA Request/Notification Form 2005-2024

FMLA leave. Supervisor initiates form and sends a copy to the employee if the purpose is to notify employee that his/her absence is considered FMLA-covered. Section A. - Employee Information Employee Name: Employee Title: Unit: Section B.1. This section required only if employee is initiating form. I hereby request authorization for FMLA leave as shown in Section C below. I understand that I must be on approved annual, sick or compensatory leave (non-payable), or leave without pay in conjun.

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