DE 2501F PDF

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Dw are not required to provide the PFL claim forms to their employees. To submit by US mail you must first order a claim form. You may need to download the free Adobe Reader to view and print linked documents.

Deaf, speech impaired, and hard of hearing callers can contact PFL directly by Teletypewriter TTY this number does not accept voice calls.

Paid Family Leave – Forms and Publications

Forms and Publications Labor Market Information. PFL law requires xe 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.


The EDD is unable to guarantee the accuracy of this translation and is therefore not liable for any inaccurate information or changes in the formatting of the pages d from the translation application tool. 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.

It cannot be downloaded or reproduced. Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. 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 Disability Insurance, complete the State Disability Insurance Request for Information 2501 DE E and return it to the Employment 2501c Department using the appropriate email address listed on the form.

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

All are available free of charge, whether you download or order for delivery by mail. To order an original form, visit Online Forms and Publicationsor call 2501 Inquiries about individual claims using this form will not be answered.


These brochures may be downloaded and provided as official fe to employees. The web pages currently in English on the EDD website are the official and accurate source for the program information and services the EDD provides.

For those forms, visit the Online Forms and Publications section. When calling via the California Relay Serviceplease provide the Paid Family Leave number to the operator. Some forms and publications are translated by the department in other languages. If any questions arise related to the information contained in the translated website, please refer to the English version.