Famu Military Leave Of Absence Request Family And Medical Leave Act (Fmla) Page 2
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1
2LEAVE USAGE CHART
Instructions: Please list the biweekly pay period, type of leave requested, and number of hours of leave that will
be used. The time reporter code must be reported along with a corresponding leave code (sick for qualifying
medical leave, vacation, compensatory, or leave without pay). The appropriate FMLA override reason code is
required for all FMLA time entry:
FMLAA (Family and Medical Leave Act Annual) - May be used for any type of absence
FMLAS (Family and Medical Leave Act Sick)
- May be used for medical/FMLA leave of absence
PRNLV (Parental Leave)
- May be used for birth or adoption of a child
Compensatory
- May be used for any type of absence (USPS employee only)
Leave Without Pay
- May be used for any type of absence
NOTE: According to the below schedule, leave will be deducted each biweekly pay period unless the Office of
Human Resources is notified in writing to modify or discontinue. This form does not apply to OPS
Biweekly Pay Period
Leave Category
Number of Hours
Employee’s Signature:________________________________________
Date: ___________________
Return completed forms to:
Office of Human Resources/Time & Labor Administration, 1700 Lee Hall Drive, 211 FHAC, Tallahassee, FL 32307
Page 2 of 2
HR_TL 04/2016
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