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

21 results found

COVID-19, Employee

Forms PFL-1 and CCOVID19 - Request for COVID-19 Quarantine PFL - ...

Learn more about Forms PFL-1 and CCOVID19 - Request for COVID-19 Quarantine PFL - Child

Employee

Form PFL-3 - PFL Family Care Leave

Translated versions available

Learn more about Form PFL-3 - PFL Family Care Leave

Employee

Form PFL-5 - PFL Military-Related Leave

Translated versions available

Learn more about Form PFL-5 - PFL Military-Related Leave

Employee

Form PFL-2 - PFL Bonding Leave

Translated versions available

Learn more about Form PFL-2 - PFL Bonding Leave

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

Discrimination

Form PFL-DC-119 - Request for Reinstatement

Learn more about Form PFL-DC-119 - Request for Reinstatement

Employee, Discrimination

Form PFL-DC-120 - PFL Discrimination/Retaliation Complaint

Learn more about Form PFL-DC-120 - PFL Discrimination/Retaliation Complaint

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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