471-070-1110 Benefits: Verification of Family Leave to Care for and Bond with a Child (1) A claimant applying for Paid Leave Oregon benefits to care for and bond with a child during the first year after the child’s birth must provide one of the following forms of verification: (a) The child's government issued birth certificate; (b) A Consular Report of Birth Abroad; (c) Legally recognized documents establishing paternity or guardianship, including but not limited to court-issued documents or administrative orders issued by the Department of Justice Division of Child Support; (d) A Voluntary Acknowledgement of Paternity (form 45-31) signed and witnessed by a hospital representative and issued within 5 calendar days of the date of birth; (e) A document issued by a health care provider of the child or pregnant parent. If issued before the date of birth, the document must be dated and signed within 60 calendar days before the expected date of birth; (f) A hospital admission form associated with delivery; (g) The Paid Leave Oregon Verification of Birth Form. If issued before the date of birth, the form must be dated and signed within 60 calendar days before the expected date of birth; or (h) Another document approved by the department for this purpose. If issued before the date of birth, the form must be dated and signed within 60 calendar days before the expected date of birth. (2) A claimant applying for Paid Leave Oregon benefits to care for and bond with a child during the first year after the placement of the child through foster care or the first year after the placement of the child through adoption must provide one of the following forms of verification that includes the child's first and last name: (a) A copy of a court order verifying placement; (b) A letter signed by the attorney representing the foster or adoptive parent that confirms the placement; (c) A document from the foster care, adoption agency, or social worker involved in the placement that confirms the placement; (d) A document for the child issued by the United States Citizenship and Immigration Services; or (e) Another document approved by the department for this purpose. (3) The verification required in sections (1) and (2) of this rule must show the following: (a) Claimant’s first and last name as parent or guardian of the child after birth or placement of the child through foster care or adoption; (b) If applying for Paid Leave Oregon benefits under section (1) of this rule, the date of the child's birth or the expected date of the child's birth; (c) If applying for Paid Leave Oregon benefits under section (2) of this rule, the date of placement; (d) Unless issued by a government entity, the document must also contain: (A) The issuer's first and last name; (B) The issuer's title or specialization; (C) The issuer's contact information, such as mailing address or telephone number; (D) The issuer's handwritten or electronic signature; and (E) The date the document was signed or issued. (4) If any of the documents listed in sections (1) and (2) of this rule do not include the full name of the claimant or, if required by this rule, the full name of the claimant’s child, or do not show the relationship of the child to the claimant, the claimant must submit one or more of the following documents to meet the verification requirements described in this rule: (a) A legal marriage certificate; (b) A certified Declaration of Domestic Partnership; (c) A legal birth certificate; (d) A notarized Voluntary Acknowledgement of Paternity Affidavit (Form 45-21); or (e) One or more documents issued by an independent and verifiable third party that establishes the parent relationship to the child. The document must be issued within six months before the claimant’s start of leave. (f) One or more documents showing that the claimant is in an in loco parentis relationship with the child. The department may consider the following documents alone or in combination to determine whether the claimant has assumed an in loco parentis role with respect to the child: (A) A valid power of attorney granting the claimant authority to care for and make decisions for the child; (B) A court order establishing the claimant as custodian of the child; (C) Documentation showing that the claimant has assumed caregiving responsibilities in association with a legal parent’s incarceration; (D) The claimant’s most recent federal or state tax return listing the child as a dependent; (E) A letter from a childcare provider, school, or health care provider identifying the claimant as a primary caregiver for the child; (F) Documentation showing regular financial support to the child; (G) Health insurance documentation listing the child as a covered dependent under the claimant’s policy; and (H) Other documentation approved by the department that demonstrates an in loco parentis relationship consistent with the factors listed in OAR 471-070-1000. [Publications: Contact the Oregon Employment Department for information about how to obtain a copy of the publication referred to or incorporated by reference in this rule.] Statutory/Other Authority: ORS 657B.340 & ORS 657B.090 Statutes/Other Implemented: ORS 657B.090 History: ED 75-2025, amend filed 12/29/2025, effective 01/01/2026 ED 58-2025, minor correction filed 03/28/2025, effective 03/28/2025 ED 5-2024, amend filed 07/30/2024, effective 08/01/2024 ED 2-2024, temporary amend filed 03/13/2024, effective 03/15/2024 through 09/10/2024 ED 9-2022, adopt filed 07/22/2022, effective 07/22/2022