The DE 2503F is a California wage sample form issued by the Employment Development Department. Employers complete and return this form when an employee files for State Disability Insurance (SDI) benefits or Paid Family Leave (PFL). The data reported on this form directly determines the employee's weekly disability insurance benefit payment.
California's SDI program covers most employed workers in the state. Contributions are funded through mandatory employee payroll deductions at a rate set annually by the EDD. When an employee becomes disabled or takes qualifying family leave, the employer must provide a wage history so the EDD can calculate an accurate benefit amount.
The form covers a broad range of wage types. Employers must report all of the following if paid during the claim period:
Each wage category is listed separately on the form. Entering wages in the correct field ensures the EDD can verify the amounts against payroll records. Errors or omissions can delay benefit payments or reduce the claimant's rate, which is why careful attention to each line is important.
Once the employer submits this wage sample, the EDD applies the SDI formula to calculate the weekly benefit. The amount is typically 60 to 70 percent of the employee's highest-earning quarter wages, subject to the annual state maximum. A complete submission helps the EDD process claims faster and pay the correct benefit on time.
| Question | Answer |
|---|---|
| Form Name | DE 2503F Form |
| Issuing Agency | California Employment Development Department (EDD) |
| Form Purpose | Wage sample for SDI and Paid Family Leave claims |
| Who Completes It | Employer or authorized payroll representative |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | de 2503 pdf, de 2503f, de 2503 rev 6 3 12, de2503 |