DE 2501F PDF

DE 2501F PDF

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If any questions arise related to the information contained in the 201f website, please 5201f to the English version. 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. If you are a woman currently receiving Disability Insurance pregnancy-related benefits, it is not necessary to request a Claim for Paid Family Leave Benefits.


These brochures may be downloaded and provided as official notices to employees.

Paid Family Leave – Forms and Publications

Some forms and publications are translated by the department in other languages. 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 new child.

You may need to download the free Adobe Reader to view and print linked documents. Deaf, speech impaired, and hard of hearing callers can contact PFL directly by Teletypewriter TTY this number does 25501f accept voice calls. When calling via the California Relay Serviceplease provide the Paid Family Leave number to the operator.

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

Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. For those forms, visit the Online Forms and Publications section.

To submit by US mail you must first order a claim form. It cannot be downloaded or reproduced. 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 email address listed on the form.


The web pages currently in English on the EDD website are the official and accurate source for the program information and services the EDD provides.

Inquiries about individual claims using this form will not be answered. Employers are not required to provide re PFL claim forms to their employees.

All are available free of charge, whether you download or order for delivery by mail. Forms and Publications Labor Market Information. To order an original form, xe Online Forms and Publicationsor call If you have not received this form within 10 days after your disability claim ends, please call