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View Information Collection (IC)

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 (Family and Medical Leave Act) WH-381.pdf Yes No Fillable Printable

Workforce Management Labor Rights Management


290,304 194,123
Private Sector Businesses or other for-profits, Farms, 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 11,570,155 0 0 -411,738 0 11,981,893
Annual IC Time Burden (Hours) 1,928,359 0 0 -68,623 0 1,996,982
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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