Retain copy of completed Section A.
Claim type: check the appropriate box for care for family member, bond with child, or military assist.
SSN: a claim cannot be processed without an accurate SSN.
Benefits denied: include with this form a copy of the claimant's denial letter.
Adjustment: use if a previous report was submitted, and this is a correction or change to that report.
| Question | Answer |
|---|---|
| Form Name | DE 2523F |
| Form Length | 3 pages |
| Fillable? | Yes |
| Fillable fields | 68 |
| Avg. time to fill out | 12 min |
| Edition | Rev. 7 (12-20) |
| Filing deadline | Section A within 15 days after receipt of a first claim for paid family leave benefits; Section B within 35 days after final payment for each period of Voluntary Plan Family Leave |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | DE 2523F, DE2523F, EDD DE 2523F, 2523F, Report of Voluntary Plan Family Leave Claim |
| Official source | DE 2523F (Rev 12-20), California Employment Development Department |
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