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Form WH-382 Designation Notice under the Family and Medical Leave Ac
The Family and Medical Leave Act of 1993, As Amended
WH-382 02.05.20
Notice to Employee of FMLA Designation (Private Sector)
OMB: 1235-0003
OMB.report
DOL/WHD
OMB 1235-0003
ICR 202302-1235-002
IC 182081
Form WH-382 Designation Notice under the Family and Medical Leave Ac
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1235-0003 can be found here:
2023-06-06 - No material or nonsubstantive change to a currently approved collection
2023-04-28 - Extension without change of a currently approved collection
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