Sufficient Certification

( 1) Certification shall be sufficient if it states in writing: (a) the date on which the leave will be taken; (b) the duration of the leave; (c) the purpose for requesting the leave; (d)· the employee's signature. (2) The following certification form may be used by employers: Employee's Certification I certify that on------- I will/did take ___ hours of leave for the following purpose: D to participate in school activities directly related to the educational advancement of a son or daughter D to accompany the son or daughter of the employee to routine medical or dental appointments such as check- ups or vaccinations D to accompany an elderly relative to routine medical or dental appointments or appointments for other professional services related to the elder' s care Employee's Signature: _________ _ Date: _________ _