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Request for Family and Medical Leave (FMLA)
Eligible employees are entitled under the Family and Medical Leave Act (FMLA) to take job-protected leave for certain family and medical reasons. Employees are eligible for FMLA leave if they have worked for at least one year, and for 1,250 hours over the previous 12 months. A FMLA leave of absence is a leave without pay; however, paid leave (accrued sick, annual and/or compensatory hours) may be substituted for the unpaid leave in accordance with LCTCS Policy #6.041, Family and Medical Leave for All Employees.
Handle: Document-6932
Owner: Laiche, Karen (User-23, klaich:DocuShare)DS
Wednesday, October 11, 2017 09:05:07 AM CDT
Wednesday, February 11, 2026 01:31:03 PM CST
Modified By: Laiche, Karen (User-23, klaich:DocuShare)DS
Locked By:
Allowed
Adobe Portable Document Format (.pdf) - application/pdf
2411-001 FMLA Request Form 10-10-17 Fillable PDF#.pdf
No
4
207988
No
Appears In: FMLA Forms
Preferred Version: Request for Family and Medical Leave (FMLA)