DE 2501F PDF

Published by on January 3, 2020
Categories: Finance

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Inquiries about individual claims using this form will not be answered. To order an original form, visit Online Forms and Publicationsor call Employers are not required to provide the PFL claim forms to their employees.

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

250f If any questions arise related to the information contained in the translated website, please refer to the English version. If you have not received this form within 10 days after your disability claim ends, please call For those forms, visit the Online Forms and Publications section.


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

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


Paid Family Leave – Forms and Publications

To submit by US mail you must first order a claim form. It cannot be downloaded or reproduced. All are 250f1 free of charge, whether you download or order for delivery by mail.

When calling via the California Relay Serviceplease provide the Paid Family Leave number to the operator.


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

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 are the official and accurate source for the program information and services the EDD provides.

The EDD is unable to guarantee the accuracy dr 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.

Some forms and publications are translated by the department in other languages. Forms and Publications Labor Market Information.

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