Family and Medical Leave Request

Document Number: ERD-10110
Description: This form may be used to assist in establishing leave entitlement under Wisconsin's Family and Medical Leave Law.
Division: Equal Rights
Comments: This form may be reproduced by employers.
Content Contact: Equal Rights Information
Document Attachment:
ERD-10110

***Should you require the necessary software to view the above attachment, please go to the DWD Viewers Download Page. Links to each specific vendor's site have been provided for you. Thank you.

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