Miami-Dade County, Florida, Designation of Family and Medical Leave Notice Form

Author: Susie Wine, Littler

When to Use

A covered Miami-Dade County, Florida, employer can use this form to respond to employees' family and medical leave requests. The employer must inform the employee whether the request has been approved or denied under the federal Family and Medical Leave Act (FMLA) or the Miami-Dade County family and medical leave law, and the reason for the denial, if applicable.

Employer coverage under these laws is as follows:

• The FMLA covers employers that employ 50 or more employees in 20 or more workweeks in the current or preceding calendar year and that are engaged in commerce or in any industry or activity affecting commerce.
• The Miami-Dade County family and medical leave law applies to any employer that in the regular course of business has 50 or more employees working in Miami-Dade County for each working day during each of the 20 or more calendar workweeks in the current or preceding calendar year.

Customizable Form