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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) |