FMLA Termination Letter Sample

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Walter Hammond

Manager of Human Resources, April Incorporated

100 Main Street

New Parkland, CA, 91010

September 1, 2014

Amy Halter

100 Broadway Lane

New Parkland, CA, 91010

Dear Mrs. Halter,

This letter is to inform you that your FMLA leave to attend to a serious medical condition will expire on September 13, 2014. As per the conditions of leave under the Family and Medical Leave Act as set out by the company, we must receive written notice as to your intent to return to the company. The deadline for that letter was August 30, 2014 and we are now in need of your documentation.

You may be able to apply for an extension of your FMLA leave, but it would be an extension without pay as you no longer have any paid time off remaining. Our ability to grant an extension would also depend on whether or not your department can spare you for longer time.

If an extension is not possible, then you do have the option of resigning from the company. We would hate to lose such a valuable employee, but you would have the option of reapplying to the company when you are well.

Please call me immediately at 555-422-4332 to address this issue. You can also email a scan of your letter to me at

Sincerely Yours,

Walter L. Hammond

Manager of Human Resources

April Incorporated

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