This sample form is intended for the primary purpose of internal HR/Payroll to track qualifying absences for FFCRA paid sick leave and EFMLA paid leave and can be modified to fit your needs.
While mandated benefits under FFCRA end on December 31, 2020, covered employers can voluntarily provide these benefits (if not already exhausted by employees) through March 31, 2021 and take the associated tax credit. The same daily limits and eligibility requirements apply.
Updated 12/22/20
