Notice to Employee of FMLA Designation (State, local, tribal)

Family and Medical Leave Act of 1993, As Amended

OMB: 1235-0003

IC ID: 186899

Information Collection (IC) Details

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Notice to Employee of FMLA Designation (State, local, tribal)
 
No Modified
 
Mandatory
 
29 CFR 825.301 29 CFR 825.127(c)(4) 29 CFR 825.312 29 CFR 825.305(c) 29 CFR 825.300(d)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction WH-382 Designation Notice (Family and Medical Leave Act) WH-382 Designation Notice draft 2014.pdf http://www.dol.gov/whd/forms/WH-382.pdf Yes No Fillable Printable

Workforce Management Labor Rights Management

 

89,499 70,488
   
State, Local, and Tribal Governments
 
   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 4,198,798 0 2,128 -325,294 0 4,521,964
Annual IC Time Burden (Hours) 699,800 0 354 -520,249 0 1,219,695
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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