Certification of Qualifying Exigency for Military Family Leave

A complete and sufficient certification to support a request for FMLA leave due to a qualifying exigency includes written documentation confirming a military member’s covered active duty or call to covered active duty status. Please check one of the following and attach the indicated document to support that the military member is on covered active duty or called to covered active duty status.

WH-384.pdf, 153.04 KB; (Last Modified on July 8, 2019)