Updated & Improved FFCRA Request for Leave Form

By Catherine Reuben, Charlotte Petilla, Peter Moser, Ari Kristan, Richard Loftus, Liz Monnin-Browder, David Wilson   April 24, 2020

As you may know, many businesses with under 500 employees are now subject to the Families First Coronavirus Response Act (FFCRA). To help employers comply with the new law, HRW has updated and improved our FFCRA Request for Leave Form, which incorporates the documentation requirements set forth in Frequently Asked Questions maintained by the IRS and the Department of Labor Temporary Rule released on April 1, 2020.

This form is NOT legal advice. The FFCRA is a new law, with new agency interpretations being issued almost daily, and with many unanswered questions still remaining. We provide this form as a tool for employers to assist them with FFCRA documentation requirements, pending further guidance.

Download/view our FFCRA Request for Leave Form here.

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