DE 2501F PDF

DE 2501F PDF

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It cannot be downloaded or reproduced. Forms and Publications Labor Market Information.

New Paid Family Leave (PFL) Benefits Form Required July 1

The EDD is unable to guarantee the accuracy of this translation and is therefore not liable ee any inaccurate information or changes in the formatting of the pages resulting from the translation application tool. Employers are not required to provide the PFL claim forms to their employees.

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When calling via the California Relay Serviceplease provide the Paid Family Leave number to the operator. If you have not received this form within 10 days after your disability claim ends, please call To request general program information or data about State Dee Insurance, complete the State Disability Insurance Request for Information Form DE E and return it to the Employment Development Department using the appropriate email address listed on the form.

If you are a woman currently receiving Disability Insurance pregnancy-related benefits, it is not necessary to request a Claim for Paid Family Leave Benefits.

Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. To submit by US mail you must first order a claim form.

New Paid Family Leave (PFL) Benefits Form Required July 1 –

PFL law requires employers to provide the Paid Family Leave – DE brochure only to new employees and employees who request leave to care for a seriously ill family member or bond with a new child.

All are available free of charge, whether you download or order for delivery by mail.

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Some forms ce publications are translated by the department in other languages. Deaf, speech impaired, and hard of hearing callers can contact PFL directly by Teletypewriter TTY this number does not accept voice calls. These brochures may be downloaded and provided as official notices to employees. Inquiries about individual claims using this form will not be answered.

Paid Family Leave – Forms and Publications

If any questions arise related to the information contained in the translated website, please refer to the English version. For those forms, visit the Online Forms and Publications section.

The web pages currently in Df on the EDD website are the official and accurate source for the program information and services the EDD provides. To order an original form, visit Online Forms and Publicationsor call