DE 2501F PDF

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Deaf, speech impaired, and hard of hearing callers can contact PFL directly by Teletypewriter TTY this number does 2501d accept voice calls. 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 resulting from the translation application tool.

Paid Family Leave – Forms and Publications

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. To submit by US mail you must first order a claim form.


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. Some forms and publications are translated by the department in other languages. You may need to download the free Adobe Reader to view and print linked documents.

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

For those forms, 2501r the Online Forms and Publications section. 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. To order an original form, visit Online Forms and Publicationsor call If any questions arise related to the information contained in the translated website, please refer to the English version.

When calling via the Ve Relay Serviceplease provide the Paid Family Leave number to the operator. Employers are not required to provide the PFL claim forms to their employees.


If you have not received this form within 10 days after your disability claim ends, please call It cannot be downloaded or reproduced. Inquiries about individual dw using this form will not be answered. Forms and Publications Labor Market Information.

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

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

Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. To request general program information or data about State Disability Insurance, complete the State Disability Insurance Request for Information Form DE Dee and return it to the Employment Development Department using the appropriate email address listed on the form.

These brochures may be downloaded and provided as official notices to employees.