FMLA Designation Forms

EZ-428
$15.95 / EA
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1 $15.95
10 $13.95 Save 13 %
25 $11.95 Save 25 %
50 $9.95 Save 38 %
100 $7.95 Save 50 %
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The Department of Labor's revised FMLA regulations require employers to provide a written designation notice to eligible employees on leave to notify them that the leave has been designated as counting toward their 12-week allotment. Such notice must be given within five business days of the leave request. The final regulations included a prototype of the notice to be used by or adapted by covered employers.

To help covered employers comply with this notice requirement, Personnel Concepts has made the DOL's model notice form available in packs of 25.