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Claim for Paid Family Leave (PFL) Benefits (DE 2501F) - English: You must submit an original form provided by the EDD. This form cannot be downloaded or reproduced. To submit the DE 2501F electronically, visit How to File a Paid Family Leave Claim in SDI Online .
- Claim by Mail
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- Claim by Mail
To file a PFL Care claim online, you must complete and submit sections one through five of the SDI Online application, then download and print the Claim for Paid Family Leave (PFL) Care Benefits (DE 2501FC) from the link on your confirmation page.
Paid Family Leave (PFL), a worker-funded program, provides benefits to eligible orkers who have a full or partial loss of wages due to the need to care for a seriously ill family member or to bond with a new child.
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make this authorization to support my care provider’s claim for Paid Family Leave benefits. I understand that I may not revoke my authorization to avoid prosecution or to prevent EDD’s recovery of monies to which it is legally entitled.
Open the file saved on your computer. Edit the file. Warning. These are the most frequently requested U.S. Department of Labor forms. You can complete some forms online, while you can download and print all others. Forms by Title. (Form Number - 5500; Agency - Employee Benefits Security Administration)
GUIDE FOR COMPLETING A CLAIM FORM FOR PAID FAMILY LEAVE (PFL) BENEFITS (DE 2475) State Disability Insurance (SDI) offers secure and convenient online options for filing PFL claims. For faster processing, submit a claim form and documentation on SDI Online at www.edd.ca.gov/disability.