(INSERT DEPARTMENT LETTERHEAD)

(DATE)

CONFIDENTIAL – (SENT VIA EMAIL or HAND-DELIVERED) – Choose one

(Employee Full Name)
(UIN)
(Employee Classification)
(College/Unit)

Denial – Not a Qualified Relationship

Dear (Employee Name):

We have received your request for  Family and Medical Leave for a (person’s relationship to the employee); however, a (same as above) is not a relationship covered by FMLA.  Therefore, you are not eligible for FMLA leave.

Please contact the (DepARTMENt) Human Resources department at (phone number) with questions and for further information regarding your eligibility for Family and Medical Leave.

Sincerely,

(Full Name)
(Classification)

Enclosure:	Employee Resource List

c: 	(Employee’s Supervisor) 
      	Department Medical File

*Note: Please contact Illinois Human Resources-Labor and Employee Relations before issuing this letter to the employee*