Notice to Employee of Pending Cancellation of Health Benefits

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

OMB: 1215-0181

IC ID: 182234

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Notice to Employee of Pending Cancellation of Health Benefits
 
No New
 
Mandatory
 
29 CFR 825.212(a)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Workforce Management Labor Rights Management

 

140,000 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested 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 140,000 0 0 140,000 0 0
Annual IC Time Burden (Hours) 11,667 0 0 11,667 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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