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From: Employment and Social Development Canada

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Step 1: Prepare required information

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

Step 2: Gather required documents

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

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

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:

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.

Information for employers

To apply for the benefit, applicants must submit an employment form completed and signed by their recent employers. As the applicant's employer, it is your responsibility to complete this form to confirm that your employee has stopped working full-time and that their earnings were at least $5,000 in the previous calendar year, or in the 52 weeks before the incident.

For details on the information you must provide, please consult: Learn more about the Canadian Benefit for Parents of Victims of Crime program

Information for law enforcement agencies

To apply for the benefit, applicants must submit an incident report form. The Law Enforcement Agency where the incident was reported must complete this form on behalf of the applicant.

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