Form WH-381: Notice of Eligibility and Rights & Responsibilities (FMLA)
Optional DOL notice employers use to tell an employee whether they're eligible for FMLA leave and to explain their rights and responsibilities.
Easy PDF filling and editing
- Fill out forms in your browser without installing software
- Files are processed on our own server and not shared with third parties
- Instant export of the completed document in PDF format
Instructions for filling out Form WH-381: Notice of Eligibility and Rights & Responsibilities (FMLA)
This template is used for official filing and documentation. Below are detailed instructions for completing, requirement details, and submission rules.
Who needs to fill out this document?
This form is designed for use by legal entities, individuals, or authorized representatives in the following cases:
- HR teams responding to FMLA leave requests.
- Employers covered by FMLA.
- Employees who requested FMLA leave.
What you will need before starting
Before filling out the interactive form, prepare the following details and documents:
Step-by-step filling process
- Determine eligibility: Check the employee's tenure, hours and worksite size.
- Complete Part A: Indicate eligible or not eligible, with reasons.
- Complete Part B: Explain rights and responsibilities, including certification.
- Provide within 5 business days: Deliver after the leave request or knowledge of a qualifying reason.
Frequently Asked Questions (FAQ)
What if the employee isn't eligible?
Check the reason in Part A and give the notice anyway.
Is this the same as the designation notice?
No. WH-382 later designates leave as FMLA once the employer has enough information.
Is the form mandatory?
The notice is required; this form is optional.
Ready to fill out Form WH-381: Notice of Eligibility and Rights & Responsibilities (FMLA)?
Open the editor, enter the required details, and download your document in a couple of minutes.
Proceed to fill out →