DE 2501F PDF

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To order an original form, visit Online Forms and Publicationsor call To submit by US mail you must first order a claim form.

If you have not received this form within 10 days after your disability claim ends, please call 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 2501g address listed on the form.


When calling via the California Relay Serviceplease provide the Paid Family Leave number to 2501t operator. Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. Forms and Publications Labor Market Information.

If you are a woman 22501f 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 se child. Inquiries about individual claims using this form will not be answered. It cannot be downloaded or reproduced.

Paid Family Leave – Forms and Publications

For those forms, visit the Online Forms and Publications section. You may need to download the free Adobe Reader to view and print linked documents.

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


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

The web pages 25501f in English on the EDD website are the official and accurate source for the program information and services the EDD provides. If any questions arise related to the information contained in the translated website, please refer to the English version. Deaf, speech impaired, and hard of hearing callers can contact PFL directly by Teletypewriter TTY this number does not accept voice calls.

Some forms and publications are translated by the department in other 201f. 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.