minutes
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SAMPLE, this page for reference only
The Paid Family Leave (PFL) has received your request for payment information. We are unable to process your request because:
If you have any questions after reading this form call 1-800-480-3287 for DI claims, or 1-877-238-4373 for PFL claims. TTY (non-voice) access (for deaf and hearing-impaired persons only) is available at 1-800-563-2441 for DI and 1-800-445-1312 for PFL claims.
DE 2470B Rev.1 (9-21) (INTRANET)