OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Notice to Employee of FMLA Eligibility and Rights & Responsibilities (Private Sector)

IC 178568 under ICR 201910-1235-001 · OMB 1235-0003.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Notice to Employee of FMLA Eligibility and Rights & Responsibilities (Private Sector)
 
No Modified
 
Mandatory
 
29 CFR 825.300(b), (c)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction WH-381 Notice of Eligibility & Rights and Responsibilities under the Family and Medical Leave Act WH-381 02.06.20.docx https://www.dol.gov/whd/forms/WH-381.pdf Yes No Fillable Printable

Workforce Management Labor Rights Management

 

290,304 194,123
   
Private Sector Businesses or other for-profits, Farms, Not-for-profit institutions
 
   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 11,570,155 0 0 0 0 11,570,155
Annual IC Time Burden (Hours) 1,928,359 0 0 0 0 1,928,359
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.