Apply

From: Employment and Social Development Canada

Step 1: Prepare required information

Make sure you have the following information to complete your application:

your social insurance number (SIN)
your full home address and your mailing address, if they are different
the number of weeks you’re applying for
your banking information to sign up for direct deposit, including:
- your financial institution
- your branch (transit) number
- your account number
the name and phone number of recent employer(s)
the police incident report number

Step 2: Gather required documents

To complete your application, you must submit the following original completed and signed forms:

employment form signed by the employer you’re currently working for, or you worked for in the 52 weeks before the incident occurred
incident report form completed and stamped by the law enforcement agency where the incident was reported
application form (if you cannot apply online)

If you have more than 1 employer

You don’t need to submit an employment form for each one, as long as you can demonstrate you’ve earned at least $5,000 in the previous calendar year, or in the 52 weeks before the incident.

If you’re self-employed

You must complete and sign an employment form and submit your Canada Revenue Agency Notice of Assessment from the previous income tax year.

If more than 1 person applies

If more than 1 person applies and is eligible for the benefit, each applicant must complete a separate application form and submit their own employment form and incident report form
The maximum 35 weeks available will be shared between the applicants. We’ll inform you in writing if the number of weeks you requested changes because of another eligible applicant

Applicants should indicate on their application form how many weeks of payment they wish to receive. Service Canada will determine the division of weeks using a sharing mechanism if:

applicants do not tell Service Canada how many weeks of payment they wish to receive, or
if they do not agree on how to share weeks

Example: When there are 2 eligible recipients

If more than 18 weeks have been paid to the first recipient, the remaining weeks will be paid to the second recipient, or divided amongst later recipients. The first recipient will stop receiving payments.

However, if fewer than 18 weeks have been paid to the first recipient, the first recipient will continue to receive payments to week 18. The remaining 17 weeks will be paid to the second recipient, or be divided amongst later recipients.

If you prefer to have someone speak with us on your behalf, you must complete and mail us the Consent to release personal information to a designated individual form .

Step 3: Complete the application and submit required documents

Once you gathered the required information, you can apply online. You can upload your required documents at the same time you submit your application. If you do not have your required documents ready at the time of applying, you can upload them separately at a later time.

Apply online and Upload Required Documents

Apply by mail or in person

If you cannot apply for this benefit online, you may print and complete the application form, mail it to us or drop it off at a Service Canada Centre. Contact us to have a paper application form mailed to you, or to request the form in other formats.

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Date modified:: 2023-09-26

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