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How do I fill this out?
To fill out this form, begin by providing your personal information at the top. Next, select the reason for your leave from the provided options. Finally, review your choices and submit the form to the Disability Management Unit.

How to fill out the Application for Leave of Absence Michigan?
1
Start by entering your employee information.
2
Select the type of leave you are requesting.
3
Indicate your leave start and end dates.
4
Provide your leave credit options.
5
Sign and date the form before submission.
Who needs the Application for Leave of Absence Michigan?
1
Employees needing medical leave for personal health reasons.
2
Caregivers who must spend time with a seriously ill family member.
3
New parents seeking paid parental leave after childbirth or adoption.
4
Employees on military duty requiring intermittent leave.
5
Those affected by a family member's active duty in the Armed Forces.
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What are the instructions for submitting this form?
To submit this form, email it to HR-Technical-Unit@Michigan.gov or fax it to 517-241-6898. Alternatively, you can mail it to PO Box 30831, Lansing, MI 48909. Ensure your supervisor receives a copy for their records as well.
What are the important dates for this form in 2024 and 2025?
Important dates for this file include deadlines for submitting leave requests aligned with departmental policies. Look out for specific dates in your workplace regulations. This ensures compliance and timely approval of your application.

What is the purpose of this form?
The purpose of this form is to allow employees of the Michigan Department of Corrections to request leaves of absence formally. It encompasses various types of leave such as medical, maternity, and military caregiver leave. Proper completion ensures clarity in the employee's needs and facilitates prompt processing by the Disability Management Unit.

Tell me about this form and its components and fields line-by-line.

- 1. Employee's Name: The full name of the employee requesting leave.
- 2. Home Address: The current residential address of the employee.
- 3. Work Phone Number: Contact number to reach the employee during work hours.
- 4. Leave Start Date: The date when the requested leave will begin.
- 5. Leave End Date: The date when the employee plans to return to work.
What happens if I fail to submit this form?
If the form is not submitted, the employee may face issues such as being marked absent without leave. This may lead to disciplinary actions or loss of leave entitlements. It's crucial to submit the form timely to avoid these complications.
- Disciplinary Actions: Failure to submit may lead to consequences such as warnings or other disciplinary measures.
- Impact on Leave Entitlements: Not submitting the leave form might result in losing your eligibility for specific leave types.
- Payroll Issues: Absence of a submitted form could place you off payroll, affecting your salary.
How do I know when to use this form?

- 1. Medical Leave: For employees needing time off due to personal medical conditions.
- 2. Family Care Leave: To care for seriously ill family members.
- 3. Maternity Leave: For new parents taking leave following the birth or adoption of a child.
- 4. Military Leave: When caring for family in military service requiring attention.
- 5. Intermittent Leave: For sporadic leave needed for personal or health-related reasons.
Frequently Asked Questions
How do I access this leave form?
You can access the leave of absence form directly through our platform.
Can I save changes to the PDF?
Currently, you can edit and download the PDF but not save it directly.
Is there support for filling out the form?
Yes, support is available within the editor for guidance on completing the form.
What should I do if I encounter an issue?
Contact our support team for immediate assistance with any issues.
Can I use this form for intermittent leave?
Yes, this form can be utilized for requesting both continuous and intermittent leave.
How do I submit this leave application?
Submit your completed application via email or fax to the Disability Management Unit.
What if I need to change my leave dates after submission?
Notify your supervisor and resubmit the form with updated dates.
Is there a deadline for submitting this form?
It's recommended to submit it as soon as your leave need arises.
Will I be informed about my leave status?
Yes, you'll receive notifications regarding the approval of your leave application.
Can I fill this form on my mobile device?
Yes, the form is mobile-friendly for accessibility.
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