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Get and Sign the Purpose of This Form is to Request a Leave of Absence under the Family and Medical Leave Act FMLA 2018
Section 3 Reason for Leave Please Check only one My own serious health condition or pregnancy renders me unable to perform the functions of my position. The birth and/or care of a child within 12 months of date of birth. MTAHQ and BSC Employees Email or fax to the BSC at fax 212-852-8700 or bscservice mtabsc.org DOCUMENTATION REQUIRED FOR ONLINE AND PAPER FORM REQUESTS If your request for FMLA is for you or a family member with a serious health condition a medical certification is required....
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