DOL Form WH-381

View WHD's Form WH-381 Online htm
Agency: WHD
Title: Family and Medical Leave Act of 1993 (Employer Response to Employee Request for Family or Medical Leave)
Form Description: The Employer Response to Employee Request for Family and Medical Leave may be used by an employer covered by the Family and Medical Leave Act (FMLA) to satisfy its obligation (whether or not it chooses to use the form) to provide written notification detailing the employer’s specific expectations and obligations of an employee taking FMLA protected leave.
OMB Control Number: 1235-0003