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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

Reporting a situation that does not respect the law - Compulsory qualification programs (01-1047A) (PDF, 190 KB)

Non-respect of conditions applying to the carrying on of trades subject to the Act respecting Workforce vocational training and qualification (R.S.Q., c. F-5)

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

Declaration of income (6468A) (PDF, 525 KB)

This form must be completed if you are participating in an employment assistance activity, but are not receiving government income support and are not an Employment Insurance participant.

An Employment Insurance participant is a person who has received employment insurance benefits at any time in the past 60 months or has paid premiums to the Employment Insurance Program during 5 of the past 10 years.

The form is used to verify whether your income in the past 12 months and that of your family, if any, is under the low-income cut-off. The information will allow the personnel at the Ministère to determine whether you are eligible for financial assistance during your participation in an employment assistance activity. Submit the duly completed, signed and dated form to your nearest Services Québec officeOpens external link in new window..

 

 

November 2019

Follow-up sheet for a referral or recuitement activity (6478-01A) (PDF, 341 KB)

Follow-up sheet for a referral or recuitement activity to be completed by the outside partner.

September 2019

Qualification Program – Enrolment Application (01-1000) (PDF, 689 KB)

This form is the enrolment application for the following programs:

  • Regulated qualification programs - regulated qualifications
  • Regulated qualification programs - other qualification programs administered by Emploi-Québec
  • Interprovincial Standards Red Seal Program

This guide contains general information to help you complete the enrolment application: Information Guide

March 2019

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