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Form WH-384: Certification of Qualifying Exigency for Military Family Leave (FMLA)
Certifies a qualifying exigency for FMLA leave related to a covered military member being on active duty or called to active duty in a foreign country.
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DOL Form WH-384 - Certification of Qualifying Exigency for Military Family Leave (FMLA)
Certifies a qualifying exigency for FMLA leave related to a covered military member being on active duty or called to active duty in a foreign country.
Risk Radar
Scan points- 1Not meeting the qualifying exigency categories — only specific activities (attending briefings, arranging childcare, making financial/legal arrangements, etc.) qualify.
- 2Missing the return deadline — employer can require certification returned within 15 days.
Plain English
Use this form when you need FMLA leave because a spouse, child, or parent in the military has been deployed or called to active duty abroad.
Submission Date
- Filing date: Required when an employer requests certification for military family leave.
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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Field map
Compact field-by-field guide
Employee
2 items
Your full name.
Your employer's name.
Military Member
3 items
Name of your family member in the military.
Your relationship to the military member.
Which branch of the U.S. military.
Exigency
1 items
The specific qualifying exigency category.
Leave
1 items
Start and end dates of requested leave.
Signature
1 items
Your signature.
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Questions about DOL Form WH-384
What is DOL Form WH-384 used for?
Use this form when you need FMLA leave because a spouse, child, or parent in the military has been deployed or called to active duty abroad.
Who must file DOL Form WH-384?
Employees who are the spouse, child, or parent of a covered military member called to or on active duty.
What information does DOL Form WH-384 require?
A certification supporting FMLA leave for qualifying exigency activities related to military deployment.
When is DOL Form WH-384 due?
Required when an employer requests certification for military family leave.
Where do I file DOL Form WH-384?
Return to your employer's HR department.
How do I complete DOL Form WH-384?
Complete Part A with employee information. The military member or appropriate contact completes Part B. Both sign.
What happens if DOL Form WH-384 is filed incorrectly?
FMLA provides up to 12 weeks for qualifying exigency leave related to active duty of an immediate family member.
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