Indiana Request for Extended Personal Leave

State:
Multi-State
Control #:
US-300EM
Format:
Word; 
Rich Text
Instant download

Description

This form is used by an employee to request an extended leave of absence.
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How to fill out Request For Extended Personal Leave?

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FAQ

Provide enough information regarding the challenge you're facing so the reality of your needs is clear, but don't say more than you are comfortable with. Convey your commitment to the organization in the long term, and explain how granting a leave will make your future with the company possible.

Employees may take up to 12 weeks of leave in a 12-month period for a serious health condition, bonding with a new child, or qualifying exigencies. This leave is available every 12 months, as long as the employee continues to meet the eligibility requirements explained above.

Extended leave encompasses forms of leave with or without pay that last longer than 15 consecutive workdays. Extended leave may be provided for medical (self and family), parental, military, and personal reasons.

When requesting a formal leave of absence, your letter should include:Request for a leave of absence,The dates you expect to be away from work,The date you plan to return to work,An offer to provide assistance, if feasible,Thanks for considering your request.

There is no formal provision in the FMLA for extended leave beyond 12 weeks. However, it is possible for workers to negotiate an extension on a case-by-case basis by discussing their situation with their employer and requesting additional unpaid leave during a family or medical crisis.

Tell your boss or company contact person what your needs are and the likely duration of the leave a week or two (for example, until your daycare reopens) or a month or more (such as when you're dealing with the uncertainty of a family member's illness).

Some common reasons employees take a leave of absence are to recover from a serious illness, undergo a medical procedure, assist a family member, take an extended trip or welcome a new child into the family.

Some common reasons employees take a leave of absence are to recover from a serious illness, undergo a medical procedure, assist a family member, take an extended trip or welcome a new child into the family.

Here's how to ask for a leave of absence from your job:Understand your legal rights regarding time off and pay.Make the request in person.Give sufficient advance notice.If possible, work with your boss to develop an agreeable plan.Keep track of relevant paperwork.

Dear Mr./Ms. (Name of recipient), I am writing to inform you that I find myself unable to return to work on (date), and must request for a leave extension.

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Indiana Request for Extended Personal Leave