Indiana Legal Forms

FMLA request form

Indiana Family and Medical Leave Form
Indiana Family and Medical Leave Form
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Indiana Family and Medical Leave Form
This form is to be used to comply with the Federal Family and Medical Leave Act which requires that eligible employees be entitled to up to 12 weeks of unpaid and job-protected leave for certain family and medical reasons.

This form is for use in Indiana.

Among others, this form includes the following provisions:
• Eligibility
• Reasons for requested leave

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