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Document Number: ERD-8994-E
Description: This form should be used to file a Family and Medical Leave Act complaint.
Content Contact: Equal Rights Information
ERD-8994-E (English Electronic Version - Word/149 KB)
ERD-8994 (English Print Version - pdf/25 KB)
ERD-8994-S (Spanish Print Version - pdf/34 KB)
Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.