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

You may need to download the free Adobe Reader to view and print linked documents. 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.

Inquiries about individual claims using this form will not be answered. If you are a woman currently receiving Disability Insurance pregnancy-related benefits, it is not necessary 250f request a Claim for Paid Family Leave Benefits.


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

To request general program information or data about State Disability Insurance, complete the State Disability Insurance Request 250f Information Form DE E and return it to the Employment Development Department using the appropriate email address listed on the form.

It cannot be downloaded or reproduced. To order an original form, visit Online Forms and Publicationsor call For those forms, visit the Online Forms and Publications section.

If you have not received this form within 10 days after your disability claim ends, please call Deaf, speech impaired, and hard of hearing callers can contact PFL directly by Teletypewriter TTY this number does not accept voice calls. Some 251f 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.

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

When calling via the California Relay Serviceplease provide the Paid Family Leave number to 22501f operator. Forms and Publications Labor Market Information.

Employers are not required to provide the PFL claim forms to their employees. These brochures may be downloaded and provided as fe notices to employees.

Paid Family Leave – Forms and Publications

Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. The web pages currently in English on the EDD website xe 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.