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Certification of Health Care Provider for Employee’s Serious Health Condition (Family and Medical Leave Act)

ICR 201711-1235-001 · OMB 1235-0003 · Object 82286101.

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Document Metadata
File Typeapplication/octet-stream
File TitleCertification of Health Care Provider for Employee’s Serious Health Condition (Family and Medical Leave Act)
SubjectCertification, Health, Care, Provider, Employee’s, Serious, Health, Condition, Family, Medical, Leave, Act, fmla, United States,
AuthorUS Department of Labor Wage and Hour Division
File Modified2016-05-19
File Created2008-11-07
Conversion Statefailed_conversion