OMB control number

Paid Leave Under the Families First Coronavirus Response Act

OMB 1235-0031 · DOL/WHD.

OMB 1235-0031

On March 18, 2020, the President signed the Families First Coronavirus Response Act into law (Pub. L. 116-127. The Act provides for paid sick leave for some employees and an expansion of the family and medical leave law.

The latest form for Paid Leave Under the Families First Coronavirus Response Act expires 2021-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
PL 116-127 (FFCRA).pdf Supplementary Document
1235-0031 30-day FRN (published).pdf Supplementary Document
60-day FR notice 1235-0031 (85 FR 20723-20200414).pdf Supplementary Document
empsit June 2020.pdf Supplementary Document
ss1235-0031 extension 20200824.docx Supporting Statement A
ER notice to EE of failure to meet notice req (federal)
ER notice to EE failure to meet notice req (State/local/tribal)
ER notice to EE of failure to meet notice req (private)
ER recordkeeping (Federal) EPSlA
ER recordkeeping (public State/local/tribal) EPSLA
ER recordkeeping (private) EPSLA
Small Employer Exemption (State/local/tribal)
Small Employer Exemption Record (Private)
EFMLEA Employer Record (Federal)
EFMLEA Employer Record (State/local/tribal)
EFMLEA Employer Record (private)
EFMLEA Employee Notice (Federal)
EFMLEA Employee Notice (State/local/tribal)
EFMLEA Employee Notice (private)
Tax Credit Records (Federal)
Tax Credit Records (State/local/tribal)
Tax Credit Records (private)
Concurrent Leave Notice (Federal)
Concurrent Leave Notice (State/local/tribal)
Concurrent leave notice (private)
Health Benefits Notice (private)
Health Care Provider Certification (Federal)
Health Care Provider Certification (State/local/tribal)
Health Care Provider Certification (private)
Paid Sick Leave Notice of Need for Leave (Federal)
Paid Sick Leave Notice of Need for Leave (state, local, tribal)
Paid Sick Leave Notice of Need for Leave (private)

All Historical Document Collections

202005-1235-003	Revision of a currently approved collection	2020-09-22
202003-1235-002 Approved with change	New collection (Request for a new OMB Control Number)	2020-04-01

OMB Details

Paid Sick Leave Notice of Need for Leave (private)

Federal Enterprise Architecture: Workforce Management - Labor Rights Management