Independent form guide. BrieflyGo is not affiliated with or endorsed by IRS, USCIS, SSA, DOL, or any U.S. government agency. Official forms are sourced from public government websites.

USDOLRev. 06-2023

Official form guide

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.

Fillable formOpen in Editor->Download blank PDF

Need help with Form WH-384?

Open it in the AI Editor for field guidance, checks, and PDF export.

Fillable formOpen in Editor->

Form Overview

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.

A certification supporting FMLA leave for qualifying exigency activities related to military deployment.

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.

AI co-pilot

Fill it faster. Catch mistakes before you file.

Explains confusing fields in plain English
Flags missing signatures, dates, IDs, and attachments
Keeps the PDF ready for editor, send, and proof flows
Open AI workspace->

Glossary Terms

foreignparentmember

Hover a term to preview the meaning.

Field map

Compact field-by-field guide

8 fields

Employee

2 items

Employee Name

Your full name.

Requiredtext
Employer Name

Your employer's name.

Requiredtext

Military Member

3 items

Military Member Name

Name of your family member in the military.

Requiredtext
Relationship

Your relationship to the military member.

Requiredselect
Branch of Service

Which branch of the U.S. military.

Requiredselect

Exigency

1 items

Type of Qualifying Exigency

The specific qualifying exigency category.

Requiredselect

Leave

1 items

Dates of Leave Needed

Start and end dates of requested leave.

Requireddate

Signature

1 items

Employee Signature

Your signature.

Requiredsignature

Almost done reviewing the fields?

Fillable formOpen in Editor->

Form Preview

Form WH-384 page 1

Page 1

Form WH-384 page 2

Page 2

Open in AI Editor →

Quick Facts

Employees who are the spouse, child, or parent of a covered military member called to or on active duty.
A certification supporting FMLA leave for qualifying exigency activities related to military deployment.
Required when an employer requests certification for military family leave.
Return to your employer's HR department.
FMLA provides up to 12 weeks for qualifying exigency leave related to active duty of an immediate family member.
Complete Part A with employee information. The military member or appropriate contact completes Part B. Both sign.

Downloads

Blank Form WH-384↗Instructions↗

Fill Form WH-384

AI-powered guidance for every field

Fillable formOpen in Editor->

Free to start / No account required

Ready to get started?

8 fields / 5 sections / AI-powered guidance

Fillable formOpen in Editor->

Source transparency

Copyright & Licensing - US Government Forms

Independent guide

BrieflyGo links to and explains official public form sources. We are not a government agency, and this page is for general form guidance, not legal advice.

Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Verify current license terms with the source agency before reuse outside this platform.

Never sign without understanding every clause.

BrieflyGo reviews your contracts in plain English — instantly.

Try for free →