New Jersey 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

LE. FAMILY LEAVE INSURANCE BENEFITS - NEW MOTHER/BONDING (FL2) State of New Jersey 3.

Employees are eligible for leave under New Jersey's family and medical leave law if they have worked for their employers for at least one year, and have worked at least 1,000 hours in the last 12 months. Employees may take leave to care for a parent, spouse, child, parent-in-law, or partner in a civil union.

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.

You can apply online, which is the easiest way to apply for benefits.You can download, print, and fill out a paper application (FL-1), and mail it back to us at Division of Temporary Disability & Family Leave Insurance, P.O. Box 387, Trenton, NJ 08625-0387, or fax it to 609-984-4138.

To qualify for Family Leave Insurance in 2022, you must have worked 20 weeks earning at least $240 weekly, or have earned a combined total of $12,000 in the base year. The wages earned during your base year will determine the amount of weekly benefits you may receive, and the total amount you can claim in a given year.

Employees are eligible for FMLA leave if: they have worked for the company for at least a year. they worked at least 1,250 hours during the previous year, and. they work at a location with at least 50 employees within a 75-mile radius.

The NJ Paid Sick Leave Act ensures that all employers are required to provide paid sick leave to employees. Learn about your rights and how to get help.

A week (up to 13 weeks) in which you were separated from employment due to a declared state of emergency during the base year; or 2022 earned $8,500 or more during the base year. You may receive up to six weeks of Family Leave Insurance benefits in a 12-month period.

N.J.A.C. -2.2. The New Jersey Family Leave Act entitles certain employees to take up to 12 weeks of family leave in a 24-month period without losing their jobs.

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New Jersey Leave of Absence Application Form