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Paid Family Leave

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Form

PFL-DC-120 - Paid Family Leave Discrimination/Retaliation Complaint

Who Files: Employee

Where to File: This form and any attachments along with the required documentation must be sent to the employer and to:

Paid Family Leave
PO Box 9030
Endicott, NY 13761-9030

 

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    Form PFL-DC-120

    PFL-DC-120 (1-18) - Paid Family Leave Discrimination/Retaliation Complaint [PDF]

     

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