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  1. Forms. 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.

    • منابع EDD به فارسی

      توجه: اگر از EDD با شما تماس بگیرند، نام تماس‌گیرنده ممکن...

    • Punjabi

      ਨੋਟ: ਜੇਕਰ ਤੁਸੀਂ edd ਤੋਂ ਇੱਕ ਫ਼ੋਨ ਕਾਲ ਪ੍ਰਾਪਤ ਕਰ ਰਹੇ ਹੋ, ਤਾਂ...

    • Hindi

      Chętnie wyświetlilibyśmy opis, ale witryna, którą oglądasz,...

    • Armenian

      English. Մենք ձգտում ենք տրամադրել կենսական տեղեկատվություն...

  2. FMLA and CFRA help to protect your job while you are receiving Disability Insurance or Paid Family Leave benefits when you must: Take medical leave for yourself. Care for a family member who is seriously ill. Bond with a new child.

  3. Certification of Health Care Provider for Family Member's Serious Health Condition. California Department of Human Resources State of California. FAMILY AND MEDICAL LEAVE ACT (FMLA) AND CALIFORNIA FAMILY RIGHTS ACT (CFRA) Part A. For Completion by the Employee.

  4. California law guarantees job-protected leave to eligible employees with a serious health condition, who are caring for a family member with a serious health condition, or to bond with a new child (by birth, adoption, or foster placement).

  5. In California, you are entitled to wage replacements under California’s Paid Family Leave Program (PFL), which gives unemployment disability compensation benefits if you take time off to care for a family member or bond with a new child.

  6. The California Family Rights Act (CFRA) provides eligible employees with up to 12 weeks of unpaid, job-protected leave to care for their own serious health condition or a family member with a serious health condition, or to bond with a new child.

  7. This notice is provided pursuant to the Information Practices Act of 1977. The department listed below is requesting the information specified on this form: Department/Division. The information collected will be used for purposes of determining your eligibility for FMLA/CFRA/PDL benefits.

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