Forms

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

• Application for Service — General Information (3003A) (PDF, 351 KB)
• Appendix 1 — Information about Education and Employment (3003-01A) (PDF, 385 KB)
• Appendix 2 — Application for Last-Resort Financial Assistance (3003-02A) (PDF, 1.2 MB)

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

• Application for Service — General Information (3003A) (PDF, 351 KB)
• Appendix 1 — Information about Education and Employment Services (3003-01A) (PDF, 385 KB)

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 SimulAide. 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.

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.

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 office.

To find your local employment centre, use the Local Employment Centre Locator.

Form required by the local employment centre. This form is intended to provide confirmation, by your landlord or rooming-house keeper, of the information concerning your place of residence.
Submit the completed form in person or by mail to your local employment centre.

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.