Get ready to apply for Paid Family and Medical Leave (PFML) benefits

Overview 

This page describes the documents and information you'll need to fill out the application for Paid Family and Medical Leave (PFML) benefits. The fastest way to provide documents is to upload copies while you're applying online, but you can also fax or mail them in.

Download a checklist of what you need to apply.

For all types of leave

Information about you:

• Proof of your identity

• Your Social Security number or Individual Taxpayer Identification number

• Your employer’s 9-digit federal employer identification number (FEIN or EIN). You can find this on your W‑2 or 1099-MISC, or you can ask your employer.

Information about your leave:

• Whether you want to take continuous leave, reduced leave, intermittent leave, or a combination of those

• The date you told your employer you would be applying for paid leave

• The dates you want to take paid leave

• The dates of any other leave or benefits (provided by your employer, for example) that you plan to take or have recently taken. For most types of leave, you will need to include any leave taken since a year before your start date. If you are applying for family leave to care for a family member with a serious health condition, you should include any leave you took since July 1, 2021. 

• If you will be or have been receiving income during your leave: The source(s) and date(s) of that income 

• If you would like to receive your payments via direct deposit: Your account number and your bank's routing number

• If you want to enable multi-factor authentication, a phone number that can receive text messages (SMS)

• If you would like to have state and federal taxes withheld from your weekly benefit

For medical leave for your own serious health condition

Ask your health care provider to help you fill out a Certification of your Serious Health Condition form. You will use your health care provider’s answers on the certification form to fill out some parts of the application.

Additional Resources

Learn more about medical leave

For family leave to bond with a child

• The child’s date of birth, due date, or the date they arrived in your home for adoption or foster care

• Once the child is born or placed in your home, you will need to upload proof of birth or placement

Additional Resources

Learn more about family leave to bond with a child

For family leave to care for a family member

Ask your family member's health care provider to fill out a Certification of your Family Member's Serious Health Condition form. You will use the health care provider’s answers on the certification form to fill out some parts of the application.

Additional Resources

Learn more about family leave to care for a family member

For family leave for family members of active service members

Family leave to care for an active service member

Ask your family member's health care provider to fill out a Certification of your Family Member's Serious Health Condition form. You will use the health care provider’s answers on the certification form to fill out some parts of the application. 

Family leave to manage family affairs for an active service member

You’ll need to provide a copy of ONE of the following certification documents: 

• A copy of the family member’s active duty orders 

• A letter of Impending activation from the family member’s commanding officer 

• An FMLA WH-384 form 

Additional Resources

Learn more about family leave for family members of active service members