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Notice to Employee of FMLA Eligibility and Rights & Responsibilities (Private Sector)
No Modified
29 CFR 825.300(b), (c)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction WH-381 Notice of Eligibility and Rights & Responsibilities WH-381(2008).doc Yes Yes Fillable Fileable Signable

Workforce Management Labor Rights Management


211,170 194,123
Private Sector Farms, Businesses or other for-profits, Not-for-profit institutions
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 16,113,246 3,254,578 593,746 8,114,922 0 4,150,000
Annual IC Time Burden (Hours) 7,026,841 1,419,292 4,535,994 725,722 0 345,833
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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