Indiana Leave of Absence Application Form

State:
Multi-State
Control #:
US-AHI-269
Format:
Word; 
Rich Text
Instant download

Description

This AHI form is to be filled by an employee who is requesting a leave regarding medical, family, military, or personal leave.

How to fill out Leave Of Absence Application Form?

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FAQ

Under FMLA, employers cannot use the taking of qualified leave, such as for the birth of a child or a serious health condition, as a negative factor in any employment actions, including promotion, discipline, layoff, or termination.

When am I eligible for time off under the FMLA? You must have worked for your employer for at least 12 months and you must have worked for at least 1,250 hours during the last year. The employer must have at least 50 or more employees within 75 miles of where you work.

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year. It also requires that their group health benefits be maintained during the leave.

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.

Use the following steps:In the subject line of the email put the reason, (Leave of Absence Request, Request for Leave of Absence) followed by your full name.In the body of the email, begin with the salutation and the addressee's name.Explain the leave of absence request.Include a closing.Include your name.

When am I eligible for time off under the FMLA? You must have worked for your employer for at least 12 months and you must have worked for at least 1,250 hours during the last year. The employer must have at least 50 or more employees within 75 miles of where you work.

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.

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.

FMLA leave is unpaid, but employees may be allowed (or required) to use their accrued paid leave during FMLA leave. When an employee's FMLA leave ends, the employee is entitled to be reinstated to the same or an equivalent position, with a few exceptions.

In order to be eligible to take leave under the FMLA, an employee must (1) work for a covered employer, (2) work 1,250 hours during the 12 months prior to the start of leave, (3) work at a location where 50 or more employees work at that location or within 75 miles of it, and (4) have worked for the employer for 12

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Indiana Leave of Absence Application Form