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Loss of Income
Download the Forms
You may wish to download PDF versions
of the forms relevant to your Loss of Income claim. Use them
to practice before filling out the actual forms.
Please note that you need to fill out the official printed
forms which the Administrator will mail to you.
NOTE: You will need Acrobat
Reader to view these PDF documents.
- Form GEN
10: Loss of Income/Support - Master Form (Assistance
in filling out this form)
- Form GEN
10A: Supplemental Income/Information Form - Federal
- Form GEN
10B: Supplemental Income/Information Form - Provincial
- Form GEN
10C: Self-Employment Information Form
- Form GEN
11: Activities of Employment (Complete this Form for
some claims for Loss of Income)
- Form GEN
19: Authorization to Release Employee's Information
Form (Complete this Form if making a claim for Loss of Income/Loss
of Support)
- TRAN
2 / HEMO 2
Treating Physician Form
- Indexation
Chart
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