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Njfli form 2010-2019-2026
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- Click ‘Get Form’ to open the njfli form in the editor.
- Begin with Part A. Fill in your full name, address, and Social Security Number clearly. Ensure all information is legible to avoid processing delays.
- Indicate the reason for your family leave by selecting either 'Care of Family Member' or 'Bond With Child'. If applicable, complete Part B for bonding claims or Part C for caregiving claims.
- If claiming intermittent leave, complete Part E by listing the dates you were absent from work. Make sure to include your name and Social Security Number on this schedule.
- Review all sections carefully before signing. Ensure that you have included any necessary attachments and that your employer has completed Part D if required.
- Submit the completed form by mailing or faxing it to the Division of Temporary Disability Insurance as instructed on the form.
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