Paid Family Leave Forms

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If you have difficulty in obtaining the Paid Family Leave forms or need help in completing these forms, please contact the PFL Helpline at (844)-337-6303.

All Paid Family Leave Forms

8 results found available within Employer Clear All

Employer, Discrimination

Form PFL-300.5-D - Stipulation for PFL Discrimination Claim

Learn more about Form PFL-300.5-D - Stipulation for PFL Discrimination Claim

Employer, Discrimination

Form PFL-DC-130 - Employer's Response to PFL Discrimination Compl...

Learn more about Form PFL-DC-130 - Employer's Response to PFL Discrimination Complaint

Employee, Employer, Insurance Carrier

Form LAC-1 - Language Access Complaint Form

Learn more about Form LAC-1 - Language Access Complaint Form

Employer, Insurance Carrier

Form PFL-271S - PFL Statement of Rights (2023)

Translated versions available

Learn more about Form PFL-271S - PFL Statement of Rights (2023)

Employer

Form OC-406 - Notice of Retainer and Appearance on Behalf of Empl...

Learn more about Form OC-406 - Notice of Retainer and Appearance on Behalf of Employer

Employee, Employer

PFL Waiver Form

Learn more about PFL Waiver Form

Employer

Form PFL-135 - Employer Application for Voluntary Coverage (No Em...

Learn more about Form PFL-135 - Employer Application for Voluntary Coverage (No Employee Contributions)

Employer

Form PFL-136 - Employer Application for Voluntary Coverage (Cont...

Learn more about Form PFL-136 - Employer Application for Voluntary Coverage (Contributions)

Paid Family Leave Forms

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