Frequently Used Forms
Two-Year Independence Test 
This form is used to demonstrate you have met the eligibility criteria of the two-year independence requirement for income assistance.
Direct Deposit Request
This form is used to set up direct deposit of your income assistance or disability assistance payment to your bank account.
Self-Employment Program Monthly Reporting Worksheet
This worksheet is for use by clients participating in an approved ministry Self-Employment Program. It is a tool to assist clients to complete the Self-Employment Program Client Monthly Report.
Shelter Information
This form is used to provide the Ministry of Social Development with required rental information for your file. Applicants and recipients of income assistance, disability assistance or hardship assistance may use this form when requesting money to pay rent and/or security deposits.
Request for Non-Local Medical Transportation Assistance 
This form is used to request non-local medical transportation assistance.
Child in the Home of a Relative (CIHR) Screening Consent
This form is part of the eligibility review process for income assistance under the Child in the Home of a Relative (CIHR) program. The Child in the Home of a Relative (CIHR) program provides financial support to children who are placed in a relative’s home by their parents when the parents are unable to assume full responsibility for supporting the child.
Consent to Dismiss Appeal of Employment and Assistance Appeal Tribunal ("Tribunal")
This form is to be used by an employment and income assistance client that has filed a Notice of Appeal to the Tribunal and has now decided not to continue with the appeal. When the Tribunal receives the completed form it will cancel any scheduled Tribunal hearing and send the parties a letter advising that the client’s appeal has been dismissed.
