Resources
You can download, print, and use these Paid Leave Oregon resources to learn more about the program or share with employees.
Resources available in other languages
Resources in English, Español, Русский, 简体中文, 繁体中文, Tiếng Việt, 한국어, and العربية can be accessed by using the top navigation bar. Resources in additional languages are found here:
Forms
Find Paid Leave forms in one place, so you can quickly and easily find what you’re looking for.
Equivalent Plan Application
DownloadEquivalent Plan Report
Learn moreSelf-Employed Coverage Form
DownloadSelf-Employed Income Verification Form
DownloadTerminate Self-Employment Coverage Form
DownloadApplication for Benefits
DownloadVerification of Birth Form
DownloadVerification of Serious Health Condition Form
DownloadRequest for Hearing
DownloadEquivalent Plan Dispute Resolution Form
DownloadAssistance Grant Application and Grant Agreement
DownloadAuthorization for Electronic Deposit
DownloadSupplemental Employers Form
DownloadSafe Leave Verification Form
DownloadAuthorization for Tax Withholding
DownloadCustomer Information and Records Request
Learn moreFact sheets
Get quick answers to questions you have about how Paid Leave Oregon works.
Checklists
Download or print a checklist to help remember your next steps.
Authorized representatives
An authorized representative acts on behalf of a claimant.
Authorized Agent Fact Sheet
DownloadClaimant-Designated Representative Fact Sheet
DownloadAuthorized Representative Checklist
DownloadAuthorized Agent for a Deceased Claimant Packet
DownloadAuthorized Agent for an Incapacitated Claimant Application Packet
DownloadClaimant Designated Representative Form
DownloadAuthorized Agent for a Deceased Claimant Form
DownloadAuthorized Agent for an Incapacitated Claimant Form
DownloadGuidebooks
Employee Guidebook
DownloadEmployer Guidebook
DownloadEquivalent Plan Guidebook
DownloadSolvency Guide
Learn moreSelf-Employed Guidebook
DownloadAppeals
If you need to file an appeal, this page has information about how to get help.
Appeals
Learn moreMore resources
Additional resources
OFLA FMLA Chart
Learn moreEmployer Administered Plan Minimum Requirements
DownloadEmployer Size Instructions
DownloadWA-OR Place of Performance Letter October 2022
DownloadEquivalent Plan Model Notice Template
DownloadPrepaid Debit Card
Learn moreApproved Equivalent Plan Insurance Carriers
DownloadEmployer template
DownloadModel Notice (Poster)
The model notice poster informs employees about the benefits provided by Paid Leave Oregon and tells employees about their rights and duties under the program. Employers are required to post the model notice poster at each work site and they must provide it electronically or by mail to any remote workers.
The model notice should be displayed or sent out in the language(s) the employer uses to communicate with employees.
The poster is legal-size (8.5 inches by 14 inches) available for download and printing in 11 languages.
The model notice should be displayed or sent out in the language(s) the employer uses to communicate with employees.
The poster is legal-size (8.5 inches by 14 inches) available for download and printing in 11 languages.
Model Notice Poster-English
DownloadModel Notice Poster-Spanish
DownloadModel Notice Poster-Russian
DownloadModel Notice Poster-Vietnamese
DownloadModel Notice Poster-Simplified Chinese
DownloadModel Notice Poster-Traditional Chinese
DownloadModel Notice Poster-Somali
DownloadModel Notice Poster-Korean
DownloadModel Notice Poster-Arabic
DownloadModel Notice Poster-Farsi
DownloadModel Notice Poster-Amharic
DownloadModel Notice Poster-Laotian
DownloadAdministrative rules
Learn about Paid Leave Oregon’s administrative rules at Paid Leave Oregon rules. (This link will take you to a different site.)
Administrative Rules
Learn moreVideos
Hear from Oregon employers about what Paid Leave Oregon means to them and their employees.
