New York City Earned Sick Time Act Employee Notification Form of Intention to Use Sick Leave

Entity Mandating Form: New York City Department of Consumer Affairs

Applicability: Under New York City's Earned Sick Time Act, an employer may ask an employee to sign a form if he or she wants to use earned sick leave for a foreseeable need. A copy of the completed form should be provided to the employee as indicated on the form.

Obtaining This Form: An employer may download this form directly from the Department of Consumer Affairs website.

Additional Resources

New York City Department of Consumer Affairs