Medical Certifications and Recertifications

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

OMB: 1215-0181

IC ID: 13897

Information Collection (IC) Details

View Information Collection (IC)

Medical Certifications and Recertifications
 
No Modified
 
Required to Obtain or Retain Benefits
 
29 CFR 825.305 29 CFR 825.307 29 CFR 825.308 29 CFR 825.306

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction WH-380 Certication of Health Care Provider (FMLA) wh380.pdf http://www.dol.gov/esa/regs/compliance/whd/fmla/wh380.pdf Yes No Fillable Printable

Workforce Management Labor Rights Management

 

1,909,000 0
   
Private Sector Businesses or other for-profits
 
   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 1,909,000 0 0 -13,148,750 0 15,057,750
Annual IC Time Burden (Hours) 636,333 0 0 -733,770 0 1,370,103
Annual IC Cost Burden (Dollars) 11,301,280 0 0 11,301,280 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

© 2024 OMB.report | Privacy Policy