29 CFR Part 825, The Family and Medical Leave Act of 1993

ICR 200406-1215-001

OMB: 1215-0181

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
1215-0181 200406-1215-001
Historical Active 200306-1215-001
DOL/ESA
29 CFR Part 825, The Family and Medical Leave Act of 1993
Extension without change of a currently approved collection   No
Regular
Approved without change 08/04/2004
Retrieve Notice of Action (NOA) 06/08/2004
  Inventory as of this Action Requested Previously Approved
08/31/2007 08/31/2007 08/31/2004
15,057,750 0 15,055,550
1,370,103 0 1,369,737
0 0 0

The Family and Medical Leave Act of 1993 (FMLA) requires private sector employers of 50 or more employees, and public agencies to provide up to 12 weeks of unpaid, job-protected leave to "eligible" employees for certain family and medical reasons. Records are required so that the Department of Labor can determine employer compliance with FMLA.

None
None


No

1
IC Title Form No. Form Name
29 CFR Part 825, The Family and Medical Leave Act of 1993 WH-380, WH-381

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 15,057,750 15,055,550 0 0 2,200 0
Annual Time Burden (Hours) 1,370,103 1,369,737 0 0 366 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/08/2004


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