Forms

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

8 results found available within Employer Clear All

Employer, Insurance Carrier

PFL-271S Form (2021)

Form PFL-271S (2021) - Statement of Rights for Paid Family Leave

Learn more about PFL-271S Form (2021)

Employee, Employer

PFL-Waiver Form

Form PFL-Waiver - Employee Paid Family Leave Opt-Out and Waiver of Benefits

Learn more about PFL-Waiver Form

Employee, Employer, Insurance Carrier

LAC-1 Form

Form LAC-1 - Language Access Comment Form

Learn more about LAC-1 Form

Employer

PFL-135 Form

Form PFL-135 - Employer’s Application for Voluntary Coverage (No Employee Contribution)

Learn more about PFL-135 Form

Employer

PFL-136 Form

Form PFL-136 - Employer's Application for Voluntary Coverage for Class of Employees For Whom Paid Family Leave Benefits Are Not Required by Law (Employee Contribution Required)