Do not fax the form. •. Mail the completed form to the EDD in the envelope provided. Submit your claim no earlier than the first day your family leave begins but. Get the de f form. Description of form de f. Claim for Paid Family Leave PFL Benefits F PART A STATEMENT OF CLAIMANT CARE OR. Fill De f Form Download, download blank or editable online. Sign, fax and printable from PC, iPad, tablet or mobile with PDFfiller ✓ Instantly ✓ No software.

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Paid Family Leave – Forms and Publications

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. Any wages you received or expect to receive from your employer sick leave, paid-time-off [PTO], vacation pay, annual leave, and wages earned after you stopped working.

You may mail it with your paper form or scan and upload it to your computer to submit with your claim using SDI Online.

Visit Online Forms and Publications and order a form online. A form will be mailed to you. It cannot be downloaded or reproduced.

First and last name. To request general program information or data about State Disability 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.

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How to File a Paid Family Leave (PFL) Claim in SDI Online

fork California Driver License number. If any questions arise related to the information contained in the translated website, please refer to the English version.

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.

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. To order an original form, visit Online Forms and Publicationsor call This will delay claim processing.

How to File a Paid Family Leave (PFL) Claim in SDI Online

Forms and Publications Labor Market Information. 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.

If you are a vorm currently receiving Disability Insurance pregnancy-related benefits, it is not necessary to request a Claim for Paid Family Leave Benefits. All other claimants fodm for bonding or care claims: 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.

Make sure to put a stamp on the envelope.

For faster processing, use SDI Online to file your claim. Forms and Publications Labor Market Information.

For those forms, visit the Online Forms and Publications section. Mail your claim no earlier than the first day your family leave begins, but no later than 41 days after your family leave begins or you may lose benefits. Authorization and Statement of Care: Provide the information below ONLY if it applies to you: These brochures may be downloaded and provided as official notices to employees.

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Complete all sections of the DE FP and submit no later than 41 days from the date you wish to begin your bonding claim. Mothers without a pregnancy DI claim, new fathers, and foster or adoptive parents will need to provide a Proof of Relationship document with your bonding claim. If you have not received this form within 10 days after your disability claim ends, please call When calling via the California Relay Serviceplease provide the Paid Family Leave number to the operator.

Paid Family Leave – Forms and Publications

Employers are not required to provide the PFL claim forms to their employees. For those forms, visit the Online Forms and Publications section. Some forms and publications are translated by the department in other languages.

Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. Please note that your employer will be notified that you have submitted a PFL claim.

Follow the steps below to properly submit a PFL claim by mail.