WH-384 Summary of Edits

C hanges to form WH-384, Qualifying Exigency

General

1. Added color to WHD logo and section breaks

2. Added “Return to Employee” to heading

3. Added opening information with references to the statute, regulations, and WHD FMLA website

4. Reorganized order of information requested and instructions provided

5. Added line for employee’s name to every page

6. Changed questions to statements to be confirmed by checking a box

7. Aligned text and checkboxes

8. Added date formatting prompts

9. Bolded selected text for emphasis

10. Removed excess blank lines

11. Rephrasing for plain language, and changes to language to be consistent form to form

Section I - Employer

12. Shortened section title

13. Added regulatory reference

14. Added instruction that either the employer or employee may complete the section

15. Added date line and return by date

16. Added at least 15 calendar days instruction to date request

Section II: Employee

17. Shortened section title

18. Added checkbox options for family member relationship

19. Added definition of spouse

20. Added explanation of in loco parentis

Section II, Part A: Covered Active Duty Status

21. Changed Part A title changed to Covered Active Duty Status

22. Added checkbox options for types of written documents

Section II, Part B: Appropriate Facts

23. Changed Part B title from Amount of Leave Needed to Appropriate Facts

24. Added check box options to indicate the qualifying exigency

Section II, Part C: Amount of Leave Needed

25. Part C title changed to Amount of Leave Needed

26. Changed probable duration of qualifying exigency to best estimate of how long the exigency lasted or will last

27. Changed format, if reduced leave schedule needed

28. Changed format, if leave needed for a continuous period of time

29. Changed format, if intermittent leave needed

30. Changed format, if qualifying exigency involves Rest and Recuperation leave

Section II, Part D: Third Party Information

31. Part D title changed to Third Party Information

32. Deleted employee’s attestation

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