The Department of Labor (DOL) maintains model forms to help employers meet their notification obligations under the Family and Medical Leave Act (FMLA). Employers are not required to use the DOL’s model forms; they can customize the model forms or create their own FMLA forms.
Every three years, the DOL must submit its model FMLA forms to the federal Office of Management and Budget (OMB) for approval for continued use. The OMB’s approval for the current FMLA forms expires in 2018. This expiration date is included on the model forms in the upper right corner. The DOL has requested that the OMB reauthorize the model FMLA forms for another three-year period, until 2021, without proposing any substantive changes to the forms.
Employers may continue to use the DOL’s current model forms until new ones are released. The updated model forms are expected to be the same as the current forms, except they will have a 2021 expiration date in the upper right corner.
Employers that use the model FMLA forms can monitor the DOL’s FMLA webpage for updated model forms.Download the PDF