FMLA Forms Wisconsin

Forms Wisconsin Department Of Military Affairs

https://dma.wi.gov/DMA/humanresources/statehr/forms

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ERD 10110 Family And Medical Leave Request

https://dwd.wisconsin.gov/dwd/forms/erd/pdf/erd-10110.pdf

Title: ERD-10110, Family and Medical Leave Request Subject: This form may be used to assist in establishing leave entitlement under Wisconsin‘s Family and Medical Leave Law.
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Employee Request for W/FMLA (UWS 80) – Complete and submit this form to your institution to request W/FMLA-protected leave. If you request a WFMLA leave to care for a domestic partner or a domestic partner’s parent, you must complete this form to certify the domestic partnership for WFMLA purposes.
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FMLA De Pere Wisconsin

https://www.deperewi.gov/topic/index.php?topicid=269&structureid=103

Please see the FMLA policy for information on eligibility and qualifying FMLA reasons. City of De Pere FMLA Policy. Requesting FMLA. To request FMLA, the employee should complete Section I of the FMLA Application, have your supervisor sign, keep copy for your records, and submit to the Human Resources Office. The employee should also fill out …
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FMLA (campus) Military Family Qualifying Exigency (PDF) FMLA (campus) Parental Leave for Parent other than Birth Parent (MS Word) … PEBB – Retiree Health Insurance Enrollment Forms (PDF) Retirement – PEBB – Retiree Health Insurance Enrollment Guide (PDF) Retirement – PERS/ TRS/ LEOFF Beneficiary Designation (PDF) Retirement – UW Retirement Checklist …
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Family Medical Leave Act FMLA Toolkit Wisconsin

https://dpm.wi.gov/Pages/Employees/FmlaUsage.aspx

DOA-15322 Family and Medical Leave – Employee Request DOA-15325 Notice of Eligibility and Rights & Responsibilities (two forms combined) DOA-15324 FMLA Designation Notice DOA-15336 – Fitness for Duty Certification – Return to Work Release WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition (PDF) (federal DOL form)
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Wisconsin Family And Medical Leave Act FMLA The Law

https://www.dwd.wisconsin.gov/er/civilrights/fmla/

Wisconsin Family And Medical Leave Act (FMLA) Overview Family Medical Leave is a benefit available by state law to certain employees. The Family Medical Leave Act (FMLA) provides unpaid leave for an employee’s serious health condition, the serious health condition of a parent, child or spouse, or for the birth or adoption of a child.
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Family And Medical Leave Act Employee Request Wisconsin

https://dpm.wi.gov/Documents/DPM%20FORMS/DOA-15322.docx

State of Wisconsin. Department of Administration . Division of Personnel Management. DOA-15322 (R12/2018) s.103.10, Wis. Stats. DISTRIBUTION: Original – Designated HR File; Copy – Employee . FAMILY AND MEDICAL LEAVE (FMLA) REQUEST . TO BE COMPLETED BY EMPLOYEE. NOTE TO EMPLOYEE: All requests for FMLA must be submitted as promptly as …
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Family Amp Medical Leave Act FMLA

https://hr.wisc.edu/docs/fmla-information-guide.pdf

The federal Family & Medical Leave Act (FMLA) and Wisconsin Family & Medical Leave Act (WFMLA) are leave entitlements that enable an eligible employee to balance work and family responsibilities by taking job-protected unpaid leave for specified family and/or medical reasons. Employees can choose to be paid during an approved FMLA leave and use sick leave or other …
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