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

ICR 201711-1235-001 · OMB 1235-0003 · Object 82286201.

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File Typeapplication/octet-stream
File TitleCertification of Health Care Provider for Family Member’s Serious Health Condition (Family and Medical Leave Act)
SubjectCertification of Health Care Provider for Family Member’s Serious Health Condition (Family and Medical Leave Act), U.S. Departme
AuthorUnited States Department of Labor, Wage and Hour Division
File Modified2015-05-12
File Created2008-11-07
Conversion Statefailed_conversion