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Fill and Sign the Fmla Tracker Form 3b

Fill and Sign the Fmla Tracker Form 3b

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Open the document and fill out all its fields.
Apply your legally-binding eSignature.
Save and invite other recipients to sign it.

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FMLA Tracker Form Rolling Method – Variable schedule Employees Employee's Name ____________________________ SSN ___________________Leave Request Dated ___________________Reason for Leave ____________________________1. Beginning date of leave. ___________________2. Employee's average number of hours per week for the twelve weeks preceding the leave request ___________________ . 3. Employee's total leave allotment per twelve-month period (line 2 above multiplied by 12) ___________________. 4. Total leave used in the twelve months immediately prior to date on line 1 ________ (if leave is taken in days or weeks, convert into hours based on the average set forth on line 2). 5. Remaining available leave (line 3 minus line 4) ________. 6. Leave to be used this request (in hours) ________. 7. Leave remaining after this request (Line 5 minus line 6) ________. How to Use This Form Use this form only if you calculate leave usage under the rolling method and only if the employee at issue works variable hours. For employees with a set schedule, do not use this form.Complete a new form for each leave request.

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Adhere to this thorough guidance:

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  2. Click +Create to upload a file from your device, cloud storage, or our template library.
  3. Open your ‘Fmla Tracker Form 3b’ in the editor.
  4. Click Me (Fill Out Now) to finalize the form on your end.
  5. Add and allocate fillable fields for others (if necessary).
  6. Proceed with the Send Invite settings to request electronic signatures from additional parties.
  7. Download, print your version, or convert it into a reusable template.

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