MA PFML Notification Templates

After determining your status as an employer, you must notify all employees and contractors of the new law by September 30, 2019, or at the time of hire.

The following Word document templates may be adapted by filling in the name of your organization, its address, and federal EIN.


  • Collect a signed acknowledgement from each covered individual and keep it in their personnel file. If you do not receive the signed acknowledgement returned to the church, be certain that you have documented the delivery of the notice to the individual so that the church avoids penalties.
  • The penalty for failing to provide notice is $50 per employee or contractor for the first violation and $300 per employee or contractor for subsequent violations.