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1. edd.ca.gov › en › disabilityPaid Family Leave – Forms and Publications

   edd.ca.gov › en › disability

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   To view an example PFL claim form, review the DE 2501F – Sample claim form. Claim for Paid Family Leave (PFL) Care Benefits (DE 2501FC): If you submit your PFL claim electronically, you must submit the DE 2501FC to complete your claim, which includes the care recipient’s authorization and the physician/practitioners certification .

   • Claim by Mail

     New mothers transitioning from a DI-related pregnancy claim...

   • Disability Insurance

     Enter DE 2501 for an English form or DE 2501/S for a Spanish...

   • Forms and Publications

     The documents on this webpage are PDFs. To complete forms,...

   • Family Care Leave

     A military assist claim is complete when we receive parts A,...

   • منابع EDD به فارسی

     در زیر فهرستی از فرم‌ها، بروشورها و سایر منابع مهم edd را که...

   • Punjabi

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

   • Armenian

     English. Մենք ձգտում ենք տրամադրել կենսական տեղեկատվություն...

   • Arabic

     نحن ملتزمون بتوفير معلومات أساسية لمن يبحث عن معلومات وخدمات...

2. edd.ca.gov › siteassets › filesClaim for Paid Family Leave (PFL) Benefits (DE 2501F)

   edd.ca.gov › siteassets › files

   Paid Family Leave (PFL), a worker-funded program, provides benefits to eligible workers who have a full or partial loss of wages due to the need to care for a seriously ill family member, to bond with a new child, or to participate in a qualifying event as a result of your spouse, registered domestic partner, parent, or child’s military ...

3. edd.ca.gov › siteassets › filesGuide for Completing a Claim Form for Paid Family Leave (PFL)...

   edd.ca.gov › siteassets › files

   State Disability Insurance (SDI) offers secure and convenient online options for filing Paid Family Leave (PFL) claims. For faster processing, submit a claim form and documentation on SDI Online (edd.ca.gov/SDI_Online). To avoid delays when filing a claim using the paper application, please follow the general guidelines below.

4. d2l2jhoszs7d12.cloudfront.net › state › CAClaim for Paid Family Leave (PFL) Benefits (DE 2501F)

   d2l2jhoszs7d12.cloudfront.net › state › CA

   I 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. WE CANNOT PROCESS THIS CLAIM UNLESS YOU SIGN BOTH THIS PAGE AND PAGE 3 IN ITEM C6 OF PART C.

5. forms.edd.ca.gov › formsOnline Forms and Publications - California

   forms.edd.ca.gov › forms

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   The documents on this webpage are PDFs. To complete forms, you may need to download and save them on the computer, then open them with the no-cost Adobe Reader. Visit Accessibility if you need reasonable accommodation or an alternative format to access information on our website.

6. www.uslegalforms.com › form-library › 497963-ca-de-2501f-2020Get de 2501f form pdf 2020-2024 - US Legal Forms

   www.uslegalforms.com › form-library › 497963-ca-de-2501f-2020

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   For Disability Insurance claims, fill out and sign Part B – Physician/Practitioner's Certificate on the Claim for Disability Insurance (DI) Benefits (DE 2501) form. Mail it in within 49 days from the date your patient's disability begins.

7. d3n8a8pro7vhmx.cloudfront.net › 1458167589 › EDD_PFL_BrocurePaid Family Leave

   d3n8a8pro7vhmx.cloudfront.net › 1458167589 › EDD_PFL_Brocure

   paper form. To request a claim form, visit www.edd.ca.gov/disability. If you are currently receiving DI pregnancy-related benefits, it is not necessary to request a PFL claim form. Claim filing information will be sent through your SDI Online account or a claim form will be sent via mail when your pregnancy-related disability claim ends.