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- Family and Medical Leave Act Advisor

Qualifying Exigency Leave Certification - Required Information

§ 825.309

In addition to providing a copy of the active duty orders, an employer also may require the employee to provide a certification containing:

  • A statement or description of appropriate facts, signed by the employee, to support the qualifying exigency leave request. The facts must be sufficient to support the need for leave and include:
    • information on the type of qualifying exigency for which leave is requested;
    • any available written documentation supporting the leave (for example, a copy of a meeting announcement for informational briefings sponsored by the military, a document confirming an appointment with a counselor or school official, or a bill for services for the handling of legal or financial affairs);
  • The approximate date on which the exigency commenced or will commence;
  • The beginning and end dates if an employee requests leave for a single, continuous period of time;
  • An estimate of the frequency and duration of the exigency if an employee requests leave on an intermittent or reduced schedule basis;
  • If the exigency involves meeting with a third party, appropriate contact information for the individual or entity with whom the employee is meeting and a brief description of the purpose of the meeting; and,
  • If the qualifying exigency involves Rest and Recuperation leave, a copy of the military member’s Rest and Recuperation orders, or other documentation issued by the military indicating that the military member has been granted Rest and Recuperation leave, and the dates of that leave.

DOL has developed an optional form (WH-384) for employees’ use in obtaining a certification that meets these requirements. Form WH-384, or another form containing the same basic information, may be used. However, no information may be required beyond that specified in the FMLA regulations.

Continue to Qualifying Exigency Certification – Verification or Return to Military Family Leave Certifications.