Transcription of FAMILY AND MEDICAL LEAVE ACT (FMLA) AND ... - …
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(rev 07/2016)CalHR 753 Page of Because the LEAVE you will need will be unscheduled, it is not possible to provide the hours, days, or weeks that will be counted against your LEAVE entitlement at this time. You have the right to request this information once in a 30 calendar day period (if LEAVE was taken in the 30 calendar day period). FAMILY AND MEDICAL LEAVE ACT ( fmla ) AND CALIFORNIA FAMILY RIGHTS ACT (CFRA)Employee Last NameDesignation Notice California Department of Human Resources State of CaliforniaEmployee First NameEmployee Middle NameDateDivision/UnitDaytime Telephone Number1.
CalHR 753. Page of (rev 07/2016). Check all that apply The applicable leave regulations do not apply to your request. Part C. Leave Denial FMLA. CFRA. Military Caregiver Leave. Qualifying Exigency Leave
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