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Agenda
Reg Review
ICR
ICR Documents
Supporting Statement A
Document
Date Uploaded
ss1235-0003 20150215.docx
02/17/2015
Supporting Statement B
Document
Date Uploaded
Supplementary Documents
Title
Document
Document Type
Date Uploaded
FMLA Employee Guide
employeeguide(3.26.13).pdf
Supplementary Document
03/26/2013
60 day Federal Register Notice Renewal
FMLA 60day FR notice 9-11-14.pdf
Supplementary Document
11/14/2014
Certification for Serious Injury or Illness of a Current Servicemember-- for Military Family Leave (Family and Medical Leave Act)
WH-385 (12-19-14), trk chg.pdf
Supplementary Document
12/19/2014
Certification of Health Care Provider for Family Member's Serious Health Condition (Family and Medical Leave Act)
WH-380-F (12-19-14), trk change.pdf
Supplementary Document
12/19/2014
Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave (Family and Medical Leave Act)
WH-385-V (12-20-14),trk chg.pdf
Supplementary Document
12/19/2014
WH-380-E Certification of Health Care Provider for Employee's Serious Health Condition (Family and Medical Leave Act)
WH-380-E 7-2-15.docx
Supplementary Document
07/02/2015
Justification for Non-material change
Justification for nonmaterial change 1235-0003.docx
Justification for No Material/Nonsubstantive Change
07/02/2015
Public Comments
Author Name
Comment Document
Author Affiliation
Sponsoring Org.
Type
Category
Date of Comment
Date Comment Received
Sikorski, Krzysztof
1235-0003, Medical Cert Burden Comment.pdf
Letter
Simple
07/06/2014
08/04/2014
Leibig, Karen
Comment to DOL-WHD re FMLA Forms (11-10-14).pdf
Senior Attorney
EEOC
Letter
Simple
11/10/2014
11/10/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.