Get Ndi Fcl

The Nonindustrial Disability Insurance - Family Care Leave (Ndi Fcl) form is essential for eligible workers needing to claim benefits due to a loss of wages while caring for a family member or bonding with a new child. This guide provides straightforward instructions to help users complete the form efficiently.

Follow the steps to fill out the Ndi Fcl claim form online.

1. Press the ‘Get Form’ button to access the Ndi Fcl form and launch it for editing.
2. Complete Part A – Employee Information, which must be filled out by the Attendance Clerk or Payroll Officer.
3. Fill out Part B – Claim Statement of Employee once you have stopped working. Make sure to include your Social Security number on all pages.
4. If you are seeking benefits for bonding, complete Part C – Bonding Certification. Enclose a copy of an acceptable document listed in box 10.
5. In Part D – Statement of Care Recipient, the care recipient must fill out their details. If they are a minor or incapacitated, an authorized representative may complete this section.
6. Part E – Physician/Practitioner’s Certification must be completed by the treating physician. Ensure that rubber stamp signatures are not used as they are not accepted.
7. After filling out the applicable parts, place the signed forms into the provided envelope. Ensure that all applicable sections for your claim type (bonding or care) are included.
8. Submit the completed form to the Employment Development Department (EDD) address indicated on the form.

Complete your Ndi Fcl claim form online and get the support you need seamlessly.