Paid Family Leave Forms

Forms

Assistance with Forms

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

9 results found available within Employer Clear All

Employer, Insurance Carrier

PFL Statement of Rights (2023)

PFL-271S

Download about PFL Statement of Rights (2023)

Employer, Insurance Carrier

PFL Statement of Rights (2022)

Form PFL-271S (2022)

Download about PFL Statement of Rights (2022)

Employee, Employer, Insurance Carrier

Language Access Complaint Form

Form LAC-1

Download about Language Access Complaint Form

Employee, Employer

PFL Waiver Form

Employee Opt-Out and Waiver of Benefits

Download about PFL Waiver Form

Employer, Discrimination

Employer's Response to PFL Discrimination Complaint

Form PFL-DC-130

Download about Employer's Response to PFL Discrimination Complaint

Employer, Discrimination

Stipulation for PFL Discrimination Claim

Form PFL-300.5-D

Download about Stipulation for PFL Discrimination Claim

Employer

Employer Application for Voluntary Coverage (Contributions)

Form PFL-136

Download about Employer Application for Voluntary Coverage (Contributions)

Employer

Employer Application for Voluntary Coverage (No Contributions)

Form PFL-135

Download about Employer Application for Voluntary Coverage (No Contributions)

Employer, Discrimination

Section 32 Waiver Agreement

Form PFL-32-D

Download about Section 32 Waiver Agreement

Paid Family Leave Forms

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