WebTemporary Service in Higher Class (TSHC) (P-CB-1) FMLA: Employee Request (HR1) FMLA: Medical Certification-Employee (P33A) FMLA: Medical Certification-Caretaker (P33B) FMLA: Request/Intake Form. WC: Filing Status & Exemption (1A) WC: Concurrent Employment Third Party Liability Form (WC211) WebForm #: P33A - Employee Revision Effective Date: 1/1/2024 To be used by employee who is absent for personal illness, including FMLA absences. EMPLOYEE INFORMATION . …
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WebForm # FMLA-HR2a Revision Date: __8/2009 . This form provides employees with the information required by 29 C.F.R. 825.300 (b), which must be provided within five . business days of the employee notifying the employer of the need for federal FMLA leave. Part B provides employees with information WebThis form provided by the Department of Administrative Services . State of Connecticut Human Resources . Notice of Eligibility and Rights and Responsibilities . regarding Employee Request for . Family . Medical Leave. Entitlements (To be completed by the Human Resources Office) Form #: FMLA-HR2a. Revision Date: 3/2024. This form will: purpose of equality impact assessment
Get CT CTHR P33A 2006-2024 - US Legal Forms
WebForm #: P33A - Employee Revision Date: 4/2006 AGENCY INSTRUCTIONS To be used by employee who is absent for personal illness, including FMLA absences. This medical … Web_____ Form P33a – Employee or other sufficient medical documentation to substantiate the employee’s own illness related to COVID-19. _____ Form P33b – Caregiver or other sufficient medical documentation to substantiate that the employee is needed to care for a spouse, child, or parent with an illness related to COVID-19. ... WebThis form provided by the Department of Administrative Services State of Connecticut Human Resources Agency Response: Notice of Eligibility and Rights and Responsibilities To Employee Request for Leave of Absence under the Federal Family and Medical Leave Act (FMLA) and/or State C.G.S. 5-248a (Family and medical leave from employment) security deposit settlement statement