№ files_lp_4_process_3_139341
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This document is a certification form for employees requesting leave under the Family and Medical Leave Act (FMLA) due to a qualifying exigency related to a military member’s active duty or call to active duty status.
Year:
20xx
Region / City:
United States
Subject:
Family and Medical Leave Act (FMLA)
Document Type:
Certification Form
Agency / Organization:
U.S. Department of Labor
Author:
U.S. Department of Labor
Target Audience:
Employees seeking military family leave under the FMLA
Period of Validity:
From the date of submission
Approval Date:
N/A
Modification Date:
N/A
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The product description is provided for reference. Actual content and formatting may differ slightly.
Note:
Year
Region / City:
California
Subject:
Family and Medical Leave
Document Type:
Employee Notice
Organization:
School District
Recipient:
Employee
Applicable Period:
12-month leave cycle
Related Legislation:
Family and Medical Leave Act (FMLA), California Family Rights Act (CFRA)
Rights and Obligations:
Eligibility for leave, health benefit continuation, job protection, periodic reporting, use of paid leave
Jurisdiction:
Oregon, United States
Subject:
Employee leave entitlements
Type of document:
Informational policy table
Programs referenced:
Family and Medical Leave Act (FMLA); Oregon Family Leave Act (OFLA); Paid Leave; Short Term Disability
Covered situations:
Serious health condition; Parental leave; Sick child leave; Pregnancy related disability; Military family leave; Bereavement leave; Qualifying exigency leave; Military caregiver leave
Benefit duration:
12 to 26 weeks depending on qualifying condition
Measurement period:
52-week period; single 12-month period (for Military Caregiver Leave)
Family members covered:
Spouse; Parent; Child; Sibling; Grandparent; Grandchild; Individuals related by blood or affinity
Definition references:
Oregon state law definitions of spouse and domestic partnership
Note:
Date
Contextual description:
This document is a formal notice related to the Family and Medical Leave Act (FMLA) designation, outlining the process for leave approval and requirements for employee documentation.
Year:
2018
Region / City:
United States
Topic:
Family and Medical Leave, Employee Rights, Military Leave
Document Type:
Legal Notice
Organization / Institution:
University
Author:
Not specified
Target Audience:
University Employees
Period of Validity:
January 1, 2018
Date of Approval:
January 1, 2018
Date of Changes:
Not specified
Context:
Legal notice outlining eligibility and responsibilities for Family and Medical Leave (FML) under FMLA and CFRA for eligible university employees.
Year:
Not specified
Region / Institution:
UNC Health Care System
Department:
Department of Anesthesiology / UNC Hospitals
Related Offices:
Reimbursement Office; CMS Medicare/Medicaid
Subject:
Time allocation and cost reporting
Document Type:
Internal Q&A guidance
Audience:
NPPs, CRNAs, Adjunct Faculty, clinical staff
Program Reference:
Time Trex time study
Regulatory Framework:
CMS Medicare/Medicaid cost reporting requirements
Scope:
Clinical services, resident training, academic instruction, grant-funded activities, hospital services, and administrative duties
Contact Information:
Reimbursement Office (966-5032)
Note:
Date
☐ Caregiver – Intermittent – Patient’s Name:
Relationship to you:
☐ Caregiver – Block of Time – Patient’s Name:
Relationship to you:
Year:
2026
Region / City:
Seattle, WA
Subject:
Employee Leave under FMLA
Document Type:
Official HR Form
Organization / Agency:
City of Seattle Human Resources
Author:
Human Resources Manager
Target Audience:
Employees requesting FMLA leave
Effective Period:
As specified upon employee notification
Approval Date:
Not explicitly stated
Revision Date:
Not explicitly stated
Required Information:
Employee details, leave reason, certification, supporting documentation
Leave Duration:
Up to 26 workweeks in a 12-month period for servicemember care; up to 520 hours (pro-rated) for other qualifying reasons
Insurance and Benefits:
Health benefits continuation requirements, optional insurance coverage, premium payment responsibilities
Return to Work:
Job reinstatement rights, notification requirements for early return
Type of Source:
HR administrative form
Official Guidelines:
Rights and responsibilities under FMLA, eligibility criteria, documentation requirements
Form Instructions:
Completion by HR manager or designee, checkboxes and date entries required
Year:
2026
Region / City:
United States
Topic:
Family and Medical Leave
Document Type:
Request Form
Organization / Institution:
Human Resources
Author:
Human Resources Department
Target Audience:
Employees requesting leave
Period of Action:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
1993
Jurisdiction:
United States
Topic:
Employment law, family and medical leave
Document type:
Federal law summary
Issuing body:
U.S. Department of Labor
Audience:
Employees and employers
Coverage period:
Continuous since 1993
Eligibility requirements:
12 months of employment and 1,250 hours worked in previous 12 months
Leave entitlement:
12 weeks per year
Health conditions covered:
Serious physical or mental illness, pregnancy, chronic disorders, substance abuse treatment
Family members included:
Child, spouse, parent
Health care provider definitions:
Physicians, nurse practitioners, psychologists, and other certified providers
Absence types:
Planned or unforeseen for qualifying reasons
Legal protections:
Job security, continuation of health benefits, prohibition of retaliation
Note:
Year
Document Type:
Template
Organization:
YouthAdvance Australia
Author:
YouthAdvance
Target Audience:
YouthAdvance Participants
Year:
2021
Region / City:
Not specified
Topic:
Legal practice, solicitor qualification
Document type:
Template
Organization / Institution:
Not specified
Author:
Not specified
Target audience:
Individuals pursuing qualification as a solicitor
Validity period:
From 1 September 2021
Approval date:
Not specified
Date of amendments:
Not specified
Year:
2019
Region / City:
Philippines
Topic:
Medical Licensing
Document Type:
Application Form
Issuing Authority:
Professional Regulation Commission
Author:
International Affairs Office
Target Audience:
Foreign Medical Professionals
Validity Period:
Not specified
Approval Date:
May 1, 2019
Modification Date:
Not specified
Year:
2018
Note:
Region / City
Topic:
Payment Institutions, Electronic Money Institutions, Financial Regulations
Document Type:
Application Form
Authorizing Body:
Central Bank of Ireland
Target Audience:
Legal entities with qualifying holdings in payment institutions or electronic money institutions
Year:
2021
Document type:
Regulatory application form section
Framework:
Qualifying Investor Alternative Investment Fund (QIAIF)
Regulatory authority:
Central Bank
Jurisdiction:
Ireland
Scope:
Prospectus and prospectus supplement content
Applies to:
Umbrella funds, sub-funds, and share classes
Target audience:
Qualifying investors
Related legislation:
Companies Act 1990, Part XIII
Base currency disclosure:
Required
Minimum subscription:
At least €100,000
Content focus:
Fund structure, governance, investment objectives, policies, and restrictions
Year:
20XX
Region / City:
Ontario
Topic:
FIT Contract, Community Participation
Document Type:
Consent Form
Organization:
Independent Electricity System Operator (IESO)
Author:
Not specified
Target Audience:
Co-op Members, Property Owners
Effective Period:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2021
Region / City:
Georgia
Theme:
Energy, Renewable Energy, Regulations
Document Type:
Official Order
Organization:
Georgia Public Service Commission
Author:
Georgia Public Service Commission
Target Audience:
Industry professionals, energy companies, regulatory bodies
Effective Period:
Not specified
Approval Date:
March 11, 2021
Modification Date:
January 13, 2022, April 8, 2022, May 17, 2022
Year:
2023
Region / City:
Australia
Topic:
Outdoor Education, Youth Development
Document Type:
Template
Organization / Institution:
YouthAdvance
Author:
YouthAdvance
Target Audience:
YouthAdvance participants
Period of Validity:
N/A
Approval Date:
N/A
Date of Changes:
N/A
Year:
2025
Region / City:
London
Topic:
Single source defence procurement, QSCs
Document Type:
Consultation response form
Organization:
SSRO
Author:
SSRO
Target Audience:
Individuals or organisations with an interest in single source defence procurement
Action Period:
Consultation period: 2 April 2025 - 14 May 2025
Note:
Approval Date