Maricopa Arizona Leave Absence Approval Form

State:
Multi-State
County:
Maricopa
Control #:
US-281EM
Format:
Word; 
Rich Text
Instant download

Description

A company may use this form to approve a requested leave of absence by an employee.
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How to fill out Leave Absence Approval Form?

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FAQ

Dear (Supervisor / HR Manager): Please be advised that I hereby request an FMLA leave for a period of (number of weeks) in connection with my serious health condition. The leave is to start on (date). Attached is my medical note reflecting the need for FMLA leave.

Other Helpful Sites Maricopa County. (602) 506-3011. County Assessor. (602) 506-3406. County Recorder. (602) 506-3535. County Sheriff. (602) 876-1000.

Please review all fields before submitting. Complaint Line Phone Number: 602-506-6616. After Hours Non-Emergencies: Please file online complaint using form below or call Complaint Line during normal business hours (Monday - Friday 8 a.m. - 5 p.m.) Walk-in Complaints:Complaint/Violation Information. Name. Address. City.

Phone Numbers & Email Program or ServicePhoneEmailSTD Testing602-506-1678Tuberculosis Control & Prevention602-372-1407Teen Health602-372-1014Denise.Lopez@Maricopa.govVital Records - Birth & Death Certificates602-506-680524 more rows

COMMON REQUESTS Dog. Licenses. Restaurant. Ratings. Lost/Found. Pet. Immunizations/ Vaccines. STD/HIV. Testing. Elections/ Voting. Permitting. Services. County. Libraries. County. Parks.

In addition to the federal Family and Medical Leave Act (FMLA), some states have their own comprehensive family leave laws that may also require employers to grant employees time off for the birth or adoption of a child or to care for a family member with a serious illness. However, Arizona does not have such a law.

Maricopa County Public Records Maricopa Assessor. (602) 506-3406. Go to Data Online. Maricopa Recorder. (602) 506-3535. Go to Data Online. Maricopa Treasurer. (602) 506-8511. Go to Data Online. Maricopa Mapping / GIS. Go to Data Online. Maricopa NETR Mapping and GIS.

You can get up to 12 weeks of job-protected leave with continuous health insurance coverage. For the first two weeks, the employee will not receive pay, but for the remaining 10 weeks, the employee can receive pay at a rate of two-thirds the employee's regular rate of pay. Pay is capped at $200 per day, or $10,000.

FMLA leave is available to Arizona employees who need time off to: recuperate from a serious health condition. care for a family member with a serious health condition.

I am hereby kindly requesting you to approve my sick leave for. days from (Date) till (Date). I am suffering from (Name of the Disease) and the doctor has strictly advised hospitalization from tomorrow onwards. I am already on medication and could somehow manage to come to work today.

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Maricopa Arizona Leave Absence Approval Form