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Title:	EPSL-EFMLA LEAVE REQUEST
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Handle:	Document-112144
Owner:	Russell, Jeffery (User-6456, 08813:EVERETT)^DS
Create Date:	Thursday, April 30, 2020 04:08:21 PM PDT
Modified Date:	Friday, March 19, 2021 03:03:23 PM PDT
Modified By:	Kummerle, Christina (User-398, 08833:EVERETT)^DS
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Abstract:	Page 1 – Continue Form on Reverse ©2020 MTSBA EMPLOYEE REQUEST FORMEMERGENCY PAID SICK LEAVE - EMERGENCY FMLAEmployees may be entitled to Emergency Paid Sick Leave (EPSL) and / or Emergency FMLA (EFMLA) in accordance withthe Families First Coronavirus Response Act (FFCRA) if the employee satisfies eligibility standards. □ I am quarantined on the advice of a health care provider. Name(s) of the individual(s) being cared for: _ □ I am experiencing a substantially similar condition as specified by the Secretary of Health and Human Services, inconsultation with th...
Add Versions:	Allowed
Author:	BENEFITS
Content Type:	Adobe Portable Document Format (.pdf) - application/pdf
File name:	EPSLA-EFMLA LEAVE REQUEST 5.22.2020.pdf
Is Placeholder:	No
Max Versions:	4
Size:	212171
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Ready for Declare:	No
Appears In:	LEAVE OF ABSENCE INFORMATION
Preferred Version:	EPSLA-EFMLA LEAVE REQUEST