Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Employee Notice of Need for FMLA Leave New 4150000 69167 0
Fitness-For-Duty Medical Certifications New 207500 34583 614200
Key Employee Notifications New 62250 5188 0
Medical Certifications and Recertifications Modified 1909000 636333 11301280 Form and Instruction WH-380 Certication of Health Care Provider (FMLA)
Notice to Employees of Change of 12-Month Period for Determining FMLA Entitlement New 39100 6517 0
Recordkeeping New 4150000 207500 0
Written Guidance to Employees of FMLA Rights (Handbooks/Manuals) New 391000 65167 0
Written Notice to Employees of their FMLA Obligations and Employer Expectations New 4150000 345833 0 Form and Instruction WH-381 Employer Response to Employee Request for Family or Medical Leave
Total burden requested under this ICR: 15058850 1370288 11915480  
To view an IC, click on IC Title