How to complete your Work-Sharing agreement application

From: Employment and Social Development Canada

On this page

The following provides instructions for completing the Work-Sharing application form (EMP 5100). The box numbers listed correspond to the box numbers in the application form.

General information

Box 1: Type of application

Provide the type of Application to the Work-Sharing program you are submitting:

  • initial Application for up to 76 weeks, or
  • amendments
    • a 50 week Amendment to a current 26-week Work-Sharing Agreement
    • a 38 week Amendment to a current 38-week Agreement
    • an Amendment to a Work-Sharing Unit, for which you will need to provide information in Part 2 of this application form

Requested start and end date (must start on a Sunday and end on a Saturday)

  • Your requested start date must be no later than 60 calendar days after the application date. Please add to the requested start date the number of calendar days that apply (38 weeks = 266 days / 50 weeks = 350 days / 76 weeks = 532 days).

Box 2: Agreement number and end date (if applicable)

Provide the previous Agreement number that was issued to the employer and employer representative and include the start date (for example: May 20, 2020).

Box 3: Has your company submitted 1 or more applications to any other processing centres? If yes, please indicate where it has been submitted

If you have submitted 1 or many applications to another processing centre, indicate in which region(s) it was submitted by checking the appropriate boxe(s).

Part 1: Employer information

Box 4: Name of employer

Provide the name by which the business is commonly known.

Box 5: Date business established in Canada

Enter the date the business was established in Canada (YYY-MM-DD).

Box 6: Legal name of employer

Enter the legal name of your organization. This name is associated with your registration with the Canada Revenue Agency.

Boxes 7, 8, 9 and 10: Street address, city/ town and province/territory and postal code

Enter the full address including, the street address, name of the city/town in which the business is located, the applicable province or territory and postal code.

Box 11: Mailing address

Enter the address to which all correspondence is to be sent if different from the address indicated in boxes 7 to 10. If not different, you can leave blank. Please provide full address with street name and number, city/ town and postal code.

Boxes 12 and 13: Telephone and fax numbers

Enter the main telephone and fax numbers normally used for business purposes including the area code.

Box 14: E-mail address

Specify the e-mail address that you wish to be used for future correspondence regarding your application.

Box 15: Website (if applicable)

If the business has a web site, provide the URL address.

Box 16: Canada Revenue Agency 15 digit business number

Enter the 15 character number that the Canada Revenue Agency assigned to the business for making remittances for employee deductions.

Box 17: Name of employer representative, email address and phone number

Please indicate the contact details of the employer representative. This person is designated by the employer to be in contact with Service Canada if the employer is unavailable.

Box 18: Name of employee representative, email address and phone number (the name also needs to be added to attachment A (EMP5101))

Please indicate the contact details of the employee representative of the non-unionized workplace. The employees must authorize the employee representative to be part of the Work-Sharing unit and to represent them by signing the agreement on their behalf.

Box 19: Name of union representative, email address and phone number (the name also needs to be added to attachment A (EMP5101))

Please indicate the contact details of the employee representative of the unionized workplace. The person should be the union steward employee and all employees of the unit must authorize the union representative to be part of the Work-Sharing unit and to represent them by signing the agreement on their behalf.

Part 2: Additional information

Box 20: Description of business – Types of goods/products

Describe briefly what your company consists of. What products or services your business is offering.

Box 21: Are your employees unionized or non-unionized

Please check the appropriate box to indicate if the employees of the Work-sharing unit are unionized or non-unionized. The box checked should reflect the information provided for the employee representative from question 18 or 19.

Box 22: Total number of employees at this location

Provide the total number of employees at the location you are applying for.

Box 23: Name of bookkeeper or accountant, area code/telephone number

Enter the name of the employee or third party responsible for preparing payroll records, taxes, and issuing of checks. Please also indicate the area code and telephone number to reach this person.

Box 24: Is the layoff or work shortage due to a labor dispute in your establishment, or with a customer, or supplier establishment?

If the work shortage is due to a labour dispute, such as a work slowdown, strike, lockout or work stoppage, within the business or with a customer or supplier, select Yes. Otherwise, select No.

Box 25: What measures will your business be undertaking during the period of the Agreement (Examples: marketing, advertisement, cost-cutting measures, product development, incentives to clients, others)

Provide a description of any measures that you will take during the agreement period, to respond to the downturn in business activity.

Part 3: Work-Sharing unit information

Box 26: Average weekly earnings per Work-sharing unit (include additional income per Work-sharing unit when calculating earnings (bonuses, tips, etc.))

Enter the average weekly earnings (over the last 6 months) for all participating employees in each Work-Sharing unit using the following formula: total weekly gross earnings and additional income of participating employees in the unit divided by the number of participating employees in the unit.

Box 27: The shortage of work is expected to be: temporary or permanent

Please select whether the shortage of work is expected to be either temporary or permanent.

Box 28: Number of employees to be laid off temporarily should Work-Sharing not be approved (anticipated)

Enter the number of employees that you estimate you will have to temporarily laid off if your Work-Sharing application is not approved.

Box 29: Number of weeks of temporary layoff should Work-Sharing not be approved (anticipated)

Estimate the number of weeks for which employees will be on temporary layoff, should Work-Sharing agreement not be approved.

Box 30: Number of employees to be placed on the Work-Sharing program including any employees who were recently laid-off (must match the list of employees in attachment A (EMP5101))

Specify the number of core employees to be included in Work-Sharing and include any employees who will be called back to work from a recent layoff.

Box 31: Are there other company employees who will not be placed on Work-Sharing, but who perform the same job duties as those on the program, if yes, specify the reason the employee(s) were not placed in the Work-sharing unit?

If there are employees who will not be included in Work-Sharing but who have the same job duties as those who are to be included, please select Yes and specify the reason why there were not placed in the Work-Sharing unit.

Box 32: Will any employee with greater than 40% of shares/ownership of the business be included in the Work-sharing unit?

If there are employees to be included in Work-Sharing unit who are also main company shareholders, please select Yes.

Box 33: Does your business have any planned shut downs? (maintenance shut downs, year-end inventory shut down). Please note that planned shut downs should not exceed 4 weeks.

Indicate whether there are any shut-downs planned for the business. If you select Yes, provide the dates (YYYY-MM-DD to YYYY-MM-DD) that you expect the shut-down to begin and end.

Box 34: Approximately how many hours/days/shifts of work per week can you offer each employee while they are on the Work-Sharing program

Provide an approximation of the hours, days, and/or shifts of work that you will be able to offer each employee who is to participate in Work-Sharing.

Box 35: What is the percentage of reduction in work hours for employees per Work-sharing unit (minimum of 10% and maximum of 60%)

Provide the estimated percentage of work reduction for employees per Work-Sharing unit for the duration of the agreement; the average reduction in business activity must be no less than 10% and no more than 60%. The average reduction should be comparable to the percentage of anticipated layoffs (Box 30) within your workforce. For a 40-hour work week, 10% of reduction in hour hours represents half a day (4 hours) and 60% represents 3 days (24 hours).

Part 4: Amendment

Box 36: Describe the requested change to the agreement and the reason for the change: (please attach a revised attachment A (EMP5101) when changes, additions or deletions are being made to the Work-sharing unit. Please date each revision).

Describe the change you want to make to your current Work-sharing agreement. You also need to modify the attachment A in consequence, if any changes are being made to the Work-Sharing unit. Please also add the proposed date of amendment change for which you would like your amendment to be effective.

Signature of employer, union and/or employee representative(s)

It is important that the parties involved, in other words the employer and union and/or employee representative(s) understand that by electronically signing the Work-Sharing application, they are making an attestation as per the following:

  • they accept that, subject to the terms of the Work-Sharing agreement, all information contained in the application provided by the employer, the union(s) or employee representative(s) will be treated as confidential in accordance with applicable legislation and used solely for the purpose of determining eligibility under the Work-Sharing program of the project described in the application, and in support of research and statistical gathering activities
  • the employer, the union(s) or employee representative(s) make application for approval by the Commission of their Work-Sharing project in accordance with Section 24 of Employment Insurance Act and Sections 42 to 49 of the Employment Insurance Regulations but agree that the preparation and filing of this application does not create any obligation on the part of the employer, the union(s), employee representative(s) or the Canada Employment Insurance Commission
  • they understand that deliberately giving false or misleading information for the purpose of entering into a Work-Sharing agreement shall be subject to penalties as provided under the Employment Insurance Act

In addition, the employer agrees to provide such documentation as may be required by the Canada Employment Insurance Commission, including copies of payroll records, for purposes of verifying the information provided in the application. Employer also has to provide the attachment A (EMP5101) with the application form for each Work-Sharing unit. If the employer requires more than 1 EMP5101 form to list the Work-Sharing unit(s), many copies of the attachment A may be used as required.

Report a problem or mistake on this page
Please select all that apply:

Thank you for your help!

You will not receive a reply. For enquiries, contact us.

Date modified: