Transcription of Certification for Serious Injury or U.S. Department of ...
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Certification for Serious Injury or U.S. Department of ...
Certification for Serious Injury or Department of labor Illness of a Current Wage and Hour Division Servicemember - -for Military Family Leave (Family and Medical Leave Act). OMB Control Number: 1235-0003. Expires: 5/31/2018. Notice to the EMPLOYER. INSTRUCTIONS to the EMPLOYER: The Family and Medical Leave Act (FMLA) provides that an employer may require an employee seeking FMLA leave due to a Serious Injury or illness of a current servicemember to submit a Certification providing sufficient facts to support the request for leave. Your response is voluntary. While you are not required to use this form, you may not ask the employee to provide more information than allowed under the FMLA.
Page 1 CONTINUED ON NEXT PAGE Form WH-385 Revised May 2015 Certification for Serious Injury or U.S. Department of Labor . Illness of a Current
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