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1 to 8 of 8 forms for the search : Social Solidarity
Title and description Release Date

Parental contribution (SR-2102A) (PDF, 154 KB)

Form to be completed by parent(s). This form must be completed when a child who is considered a dependent of his or her parents files an application for financial assistance.

July 2021

Employment services and last resort financial assistance

You must complete the three forms in order to apply for last-resort financial assistance.

  • Application for Service — General Information (3003A)
  • Appendix 1 — Information about Education and Employment (3003-01A)
  • Appendix 2 — Application for Last-Resort Financial Assistance (3003-02A)

If the application is for a couple or a family, each adult must complete the following forms:

  • Application for Service — General Information (3003A)
  • Appendix 1 — Information about Education and Employment Services (3003-01A)

However, only one Appendix 2 — Application for Last-Resort Financial Assistance (3003-02A) form needs to be completed per couple or family. Submit the duly completed forms in person or by mail to your nearest local employment centre.

Important: Your eligibility for a last-resort financial assistance program is determined as of the date on which your local employment centre receives the forms.

Before submitting your last-resort financial assistance application, you can obtain a preliminary assessment using the SimulAideOpens external link in new window.. Note, however, that this simulation may not be used for legal interpretation purposes.

Acrobat prints documents in letter format (8½ inches X 11 inches) by default. If you wish to print on legal-size paper (8½ inches X 14 inches or 215 mm by 355 mm), you must select the desired printing format.

February 2020

Application for an Administrative Reconsideration (EQ-6505A) (PDF, 116 KB)

Form that must be used to file an application for administrative reconsideration of a decision related to a program, measure or employment service. Used in cases where the decision is not subject to an application for review.

January 2020

Assessment of farm operations (SR-118A) (PDF, 256 KB)

Form required by the local employment centre at the time of the application for last-resort financial assistance benefits or during a reassessment while receiving benefits. This form is intended to provide an assessment of the value of and income derived from a farm operation. 

Submit the completed form in person or by mail to your local employment centre.

October 2015

Repayment by pre-authorized debit (CR-0035) (PDF, 100 KB)

This form must be completed in order to authorize the Ministère du Travail, de l’Emploi et de la Solidarité sociale to receive amounts by pre-authorized debit from your financial institution in order to recover an amount owed to the Ministère.

The form is a dynamic PDF form. It can be completed online and you can then print and sign it.

August 2015

Monthly statement (SR-0007-01A) (PDF, 193 KB)

To be completed only when the form usually accompanying the direct deposit notice or monthly cheque is lost. Form required by the local employment centre to report any financial, familial or other change that could affect your benefit or your eligibility for last-resort financial assistance. 

Dynamic PDF

August 2015

Application for Financial Assistance - Support Program for Workers Affected by Collective Dismissals (PDF, 142 KB)

Required form when applying for financial assistance under the Support Program for Workers Affected by Collective Dismissals.

August 2014

Authorization to Disclose Personal Information to a Journalist of Journalists form (2566A) (PDF, 51 KB)

This form allows you to authorize the Ministère de l’Emploi et de la Solidarité sociale to disclose personal information to a journalist or journalists.

Under the Act respecting Access to documents held by public bodies and the Protection of personal information, public bodies may not disclose personal information without the authorization of the person concerned.

The Ministère must therefore obtain the person’s authorization to disclose personal information before its representative can discuss the information in question with a journalist or journalists.

If you wish to authorize the Ministère to disclose information about you to a journalist or journalists, please complete and sign the form and either fax it to 418-643-9347 or mail it to the address shown below.

Important: You can fill in the form online but the completed form cannot be saved. Be sure to print one or more copies before exiting the form; if not, your information will be lost.

Responsable des relations avec les médias
Ministère de l’Emploi et de la Solidarité sociale
Direction des communications
Service Relations publiques, communication organisationnelle et productions spécialisées
425, rue Jacques-Parizeau, bureau RC.120
Québec (Québec) G1R 5A5
Telephone: 418-646-0425, extension 61087

February 2014