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Family and Medical Leave Act Request Form

Jan 28, 2020 · The purpose of this form is to request a leave of absence under the Family and Medical Leave Act (FMLA). DO NOT COMPLETE THIS FORM IF YOU HAVE APPLIED ONLINE TO APPLY ONLINE: 1) Sign on to My MTA Portal – www.mymta.info 2) Click the My Benefits Ribbon 3) Click the FMLA Request Link

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  Form, Medical, Family, Request, Leave, Family and medical leave act, Fmla, Family and medical leave act request form, Fmla request

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