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Click ‘Get Form’ to open the California Paid Family Leave form in the editor.
Begin with 'PART A – STATEMENT OF CLAIMANT'. Fill in your personal details, including your Social Security number and contact information. Ensure all fields are completed accurately to avoid delays.
If you are bonding with a new child, complete 'PART B – BONDING CERTIFICATION' and attach the required documentation, such as a birth certificate.
For caregiving claims, have the care recipient fill out 'PART C – STATEMENT OF CARE RECIPIENT', ensuring it is signed by them or an authorized representative.
Next, complete 'PART D – PHYSICIAN/PRACTITIONER’S CERTIFICATION' if applicable. This must be filled out by a licensed physician confirming the need for care.
If your claim involves military assistance, complete 'PART E – MILITARY ASSIST CERTIFICATION' and provide supporting documents as specified.
Review all sections for completeness before submitting. Use our platform’s features to save and share your completed form easily.

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What is 12 weeks Paid Family Leave in California?

Because of a new law called SB 951, starting on January 1, 2025, people on leave from work who apply for Paid Family Leave or State Disability Insurance will receive 70-90% of their regular income, (up from 60-70%), for claims starting in 2025.

What is the new law for Paid Family Leave in California?

PFL gives you up to 12 weeks of paid leave at 67% of your salary and is only eligible for represented union titles. FMLA gives you job protection up to 12 weeks but it is unpaid and you will need to concurrently use your leave time.

How long do you get paid for Paid Family Leave in California?

The California Family Rights Act (CFRA) authorizes eligible employees to take up a total of 12 weeks of paid or unpaid job-protected leave during a 12-month period. While on leave, employees keep the same employer-paid health benefits they had while working.

How long can you receive Paid Family Leave in California?

You can also file a new Claim for Paid Family Leave (PFL) Benefits (DE 2501F). If you have not returned to work or had a break in certification from your current bonding period, you may also extend your claim through a verbal certification by calling 1-877-238-4373.

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