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State of Connecticut Human Resources Employee Request

State of Connecticut Human Resources Employee Request

portal.ct.gov

Jan 01, 2022 · This form provided by the Department of Administrative Services . State of Connecticut Human Resources . Employee Request . For Medical Leave, Family Leave or Military Family Leave . For information about specific leave entitlements, contact Human Resources (To be completed by Employee) Form #: FMLA-HR1 Revision Effective Date: 1/1/22

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