Paid Family Leave Insurance - Download and Print PFL Forms, Publications and Informational Materials

Download and Print Paid Family Leave Insurance Forms, Publications and Informational Materials

En Español

The Paid Family Leave law requires employers to provide the Paid Family Leave, DE 2511, brochure only to new employees and employees who request leave to care for a seriously ill family member or bond with a new minor child. Employers are not required to provide the Paid Family Leave insurance claim forms to their employees.

Employers may download and print the Paid Family Leave, DE 2511 I, brochure (PDF) from the EDD Internet site if they wish to provide the brochure to their new employees without ordering specific supplies from EDD. This method meets the statutory requirement and can be a quick and easy way to meet your immediate needs. To order brochures and forms from EDD, please use our Internet Order form.

The forms and publications on this Web site are replicas of the official EDD forms and publications and are in Adobe's Portable Document Format (PDF). You may need to download the free Adobe Reader to view and print linked documents.

Claim Form

Claim for Paid Family Leave (PFL) Benefits - An original form must be submitted by claimants. It cannot be downloaded or reproduced. If you are a woman currently receiving SDI pregnancy-related benefits, it is not necessary to request a Claim for Paid Family Leave Benefits. You will automatically be sent a Claim for Paid Family Leave (PFL) Benefits - New Mother, DE 2501FP, when your pregnancy-related disability claim ends. If you have not received this form within 10 days after your disability claim ends please contact us at the telephone number below.
- DE 2501F - (Rev. 12-03) - To order a single claim form, please use Request a Claim Form for Paid Family Leave Benefits, or call 1-877-238-4373. For bulk orders, please use the Internet Order Form for EDD Forms and Publications. Deaf, speech impaired, and hard of hearing callers can contact PFL directly by Teletypewriter (TTY) 1-800-445-1312 (this number does not accept voice calls.)
- DE 2501F - (Rev. 12-03) - Sample claim form. An example of a properly completed Claim for Paid Family Leave (PFL) Benefits form for individuals claiming benefits to provide care.

Publications

Notice to Employees - This poster is required to be posted in the workplace of employees who are covered by Unemployment Insurance and State Disability Insurance.
- DE 1857A - Rev. 38 (2-06) - English
- DE 1857A/C/ - Rev. 36 (11-04) - Chinese
- DE 1857A/S/ - Rev. 36 (11-04) - Spanish
- DE 1857A/V/ - Rev. 36 (11-04) - Vietnamese (144k)
Notice to Employees - This poster is required to be posted in the workplace of employees who are covered only by State Disability Insurance. If your employees are also covered by Unemployment Insurance, please post the DE 1857A.
- DE 1858 - Rev. 3 (10-03) - English
- DE 1858/S/ - Rev. 3 (10-03) - Spanish
Paid Family Leave - Employers are required to provide the Paid Family Leave brochure only to new employees and persons who request leave to care for a seriously ill family member or bond with a new minor child. These brochures may be downloaded and provided as official notices to employees.
- DE 2511 - Rev. 5 (1-08) - English
- DE 2511I - Rev. 4 (1-08) - English - Printer-friendly version
- DE 2511/B - Rev. 5 (1-08) - Cambodian
- DE 2511/C - Rev. 5 (1-08) - Chinese
- DE 2511/K - Rev. 5 (1-08) - Korean
- DE 2511/L - Rev. 5 (1-08) - Laotian
- DE 2511/S - Rev. 5 (1-08) - Spanish
- DE 2511I/S - Rev. 4 (1-08) - Spanish - Printer-friendly version
- DE 2511/T - Rev. 5 (1-08) - Thai
- DE 2511/V - Rev. 6 (1-08) - Vietnamese
DE 2523F - Rev. 1 (8-04) - Report of Voluntary Plan Family Leave (VPFL) Claim
DE 2548F - (3-04) - The Medical Provider's Guide to Paid Family Leave
DE 2588 - Rev. 4 (1-08) - State Disability Insurance (SDI) and Paid Family Leave (PFL) Weekly Benefit Amounts
DE 2589 - Rev. 1 (1-08) - State Disability Insurance (SDI) and Paid Family Leave (PFL) Weekly Benefit Amounts in Dollar Increments
Fact Sheet (PDF)
- DE 8714CF - Rev. 8 (3-08) - Paid Family Leave - English
- DE 8714CF/S/ - Rev. 8 (3-08) - Paid Family Leave - Spanish

EDD HomePage | Top of Page | Contact Us
The Employment Development Department is an equal opportunity employer/program.
Auxiliary aids and services are available upon request to individuals with disabilities.