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Employment & Social Services Online Forms

a computer with a form folding/ printing out of the monitor screenOnline forms are available for you to fill, print and
hand-in to any local Employment & Social Services office. 

Please check your forms are complete and correct. Hand print clearly any information you provide on these forms.

How do I use an Online Form?

Women with head down typing into a form on a laptop.You will need to have a program called Adobe Reader installed on your computer to open and use our online forms.

You can use the “Print Form” button to print a copy and complete by hand.  You may also click to type in a field on the form and then print.

Some forms have required fields that must be completed before you can print. Some forms first require approval by your caseworker &/ other person(s) to complete. You will be required to sign any printed paper copy that requests your signature.

 

Income Reporting Statement (I.R.S) card

As a participant, you must report income received within a month. Speak with your casemanager about your specific reporting requirements.

An Income Reporting Statement card should be handed into your local Employment & Social Services office on the 16th of each month. Failure to submit this card will affect your next month’s payment.

Be sure to fill in the card correctly.  You must complete every field on this income reporting card to submit. Read each box carefully.

How Do I complete the form?
  • Enter your personal information.
  • Fill in all boxes and give proof of all income
  • If you have no income to report, write "nil" in each box
  • Complete the remaining boxes on the online form or/ print the form using the “Print Form” button. Complete the remaining empty boxes manually.
  • Take the completed & signed form to your local Employment & Social Services office.

 

Change Reporting

You must report any changes to your family size, living arrangements, shelter costs,  income and assets. Complete this form, attach any receipts and hand in to your local Employment & Social Services office on the 16th of each month. Failure to contact or submit changes to your caseworker in a timely manner will affect your monthly payment. It is very important to fill in the form correctly.  Read each box carefully.

How Do I complete the form?
  • Enter your personal information in the first two boxes that are outlined in red.
  • Complete the remaining boxes to report the change on the online form.
  • Use the “Print Form” button to print a copy of the completed report.
  • Complete any remaining empty boxes manually. Attach any receipts.
  • Take the completed & signed form to your local Employment & Social Services office.

 

Travel & Transportation costs to Medical Appointments

Ontario Works participants may be eligible to claim medical travel and transportation costs. Talk to your Caseworker for more information. Supporting documents must be attached and submitted with this form. 

How Do I complete the form?

Approval must be given by your caseworker prior to using this form.

  • Enter your personal information in the boxes that are outlined in red, and then enter your caseworker’s number.
  • When finished, print the form using the “Print Form” button.
  • Take the printed form to your medical appointment, for the medical facility to enter the rest of the information.
  • Take the completed form to your local Employment & Social Services office.
  • Attach any appointment verification items such as an appointment card or parking ticket.

 

Landlord Acceptance Letter

Ontario Works participants are required to submit this form when moving to a new residence. This form must be signed by the Landlord/ Superintendent before handing it into the local Employment & Social Services office.

How Do I complete the form?
  • Complete all fields and requested information.
  • Review all information before printing the form.  When finished, click on the Print Form button.
  • Take the printed form to your Landlord/Superintendent and have him/her sign the form.
  • Take the completed & signed form to your local Employment & Social Services office.

 

Childcare Expense Receipt

Ontario Works participants who are in receipt of childcare subsidy (licensed/ unlicensed) can submit a childcare receipt claim.

How Do I complete the form?
  • Complete all fields and requested information.
  • Review all information before printing the form.  When finished, click on the Print Form button.
  • Take the printed form to your Childcare Provider to complete the remaining information.
  • Both you and your childcare provider must sign and date the form.
  • Deliver the completed form to your local Employment & Social Services office.


Points of Interest
 
Name
 
 
Contact Information
Employment & Social Services
435 Grand Avenue West, P.O. Box 1230
Chatham, ON N7M 5L8
Phone:
519.351.8573
Toll Free:
1.800.382.4940
Fax:
519.351.5090
Contact Information
 
Employment & Social Services
435 Grand Avenue West, P.O. Box 1230
Chatham, ON N7M 5L8
Phone:
519.351.8573
Toll Free:
1.800.382.4940
Fax:
519.351.5090
Contact Information
Employment & Social Services
435 Grand Avenue West, P.O. Box 1230
Chatham, ON N7M 5L8
Phone:
519.351.8573
Toll Free:
1.800.382.4940
Fax:
519.351.5090
Contact Information
Employment & Social Services
435 Grand Avenue West, P.O. Box 1230
Chatham, ON N7M 5L8
Phone:
519.351.8573
Toll Free:
1.800.382.4940
Fax:
519.351.5090


Last updated:
Thursday, August 10, 2017
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