№ files_lp_4_process_2_65209
File format: docx
Character count: 5565
File size: 23 KB
Provides official record of employee’s FMLA eligibility, required documentation, rights and responsibilities, and procedures for leave certification and continuation of benefits.
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
Price: 8 / 10 USD
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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:
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
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
Year:
1993
Region / city:
United States
Topic:
Family and Medical Leave Act, Regulations, Compliance
Document type:
Regulatory Information Collection Request (ICR)
Agency / institution:
U.S. Department of Labor
Author:
U.S. Department of Labor
Target audience:
Employers, Employees, Public Sector Agencies
Effective period:
Ongoing
Approval date:
Not specified
Modification date:
Not specified
Year:
2025
Region / City:
Kentucky
Topic:
Sick Leave Policy
Document Type:
Policy
Organization / Institution:
Kentucky School District
Author:
Kentucky School Board
Target Audience:
Certified employees
Effective Period:
2025-2026 school year
Approval Date:
07/27/2025
Amendment Date:
None
Year:
2022
Region / City:
Singapore
Subject:
Sabbatical Leave Scheme Application
Document Type:
Application Form
Organization:
National Council of Social Service (NCSS)
Author:
NCSS
Target Audience:
Singaporean and Permanent Resident professionals in Social Work, Therapy, Psychology, Counseling, and EIPIC Teaching
Period of Validity:
From 1 April 2022
Approval Date:
Not specified
Date of Modification:
Not specified
Year:
2023
Region / City:
United States
Topic:
Telework and leave policies during the COVID-19 pandemic
Document type:
Policy guide
Organization / Institution:
Department of the Navy
Author:
Not specified
Target audience:
Civilian employees of the Department of the Navy
Period of validity:
Ongoing
Approval date:
Not specified
Date of amendments:
Updated
Year:
2025
Region / City:
Maine
Topic:
Paid Family and Medical Leave
Document Type:
FAQ
Organization:
Maine Department of Labor
Author:
Maine Department of Labor
Target Audience:
Employees in Maine
Effective Period:
May 1, 2026
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2016
Region / City:
Queensland
Topic:
Special Leave, Employment Conditions
Document Type:
Policy
Organization / Institution:
Department of Education
Author:
Department of Education
Target Audience:
Teachers, Employees
Period of Action:
Up to 5 years
Date of Approval:
N/A
Date of Changes:
N/A
Description:
Policy document outlining special leave conditions and entitlements for employees working in EQI affiliated Queensland Recognised Schools.
Plan Effective Date:
January 1, 2022
Plan last modified on:
January 1, 2025
Employer:
[Company Name]
Employee Contributions:
Employees must contribute [0.5%] of their wages
Coverage:
All employees working in Connecticut
Leave Compensation Duration:
Maximum 12 weeks in a 12-month period
Paid Leave Compensation Start Date:
No waiting period
Leaves that Qualify for Compensation:
Serious health condition, birth of a child, family care, military exigency, family violence or sexual assault
Employer Records Retention:
Minimum three years after plan termination
Employee Right to Review:
Available upon request
Plan Termination:
Does not affect eligibility for benefits from approved leaves
Year:
2019
Region / City:
Nottinghamshire
Topic:
Employment policy, staff leave
Document Type:
Policy
Organization / Institution:
Nottinghamshire County Council
Author:
Nottinghamshire County Council HR Service
Target Audience:
School staff, governing bodies, human resources
Period of Validity:
Ongoing
Approval Date:
September 2019
Amendment Date:
April 2024