Telephone: 613-342-3840
Extension: 2119
Ontario Works Forms
| Form Name | Description |
|---|---|
| Birth Certificate Application |
PDF file Application form for Birth Certificate |
| Business Income and Expenses Report |
PDF file Business income and expenses for the Ontario Works program |
| Direct Deposit Form |
Direct deposit form for the Ontario Works and Ontario Disability Support programs |
| Discretionary Benefits Request |
PDF file Application form for Discretionary Benefits |
| Employment and Participation Benefits Request Form |
PDF file Application form for Employment and Participation Benefits for the Ontario Works program |
| Exception-Based Income Reporting Request Form |
PDF file Exception-based income reporting request form |
| Homelessness Prevention Benefit Application |
PDF file |
| Income Reporting Form - Change Statement |
PDF file Income reporting form for the Ontario Works program |
| Internal Review Request Form |
PDF file Internal Review request form for Ontario Works program |
| MyBenefits Handout |
PDF file Information on MyBenefits program |
| Ontario Works Child Care Receipt |
PDF file Reporting form for monthly child care costs |
| Ontario Works Document Checklist |
PDF file Documents required when applying for Ontario Works |
| Pay Direct Authorization Form |
PDF file Authorization form for Pay Direct |
| Rent Report |
PDF file Rent Report form for Ontario Works program |
| Special Diet Allowance Form |
PDF file Application form for Special Diet Allowance |
| Transportation Request Form |
PDF file |
Contact us
Community and Social Services
Phone: 613-342-3840 x 2119
Fax: 833-775-0561
Ontario Works
Brockville – Main Office
25 Central Ave. West, Suite 200
Brockville, ON K6V 4N6
Phone: 613-342-3840 x 2119 / 1-800-267-8146
Prescott
555 King Street West
Prescott, ON K0E 1T0
Phone: 613-925-0001
Gananoque
375 William Street South, Suite 100
Gananoque, ON K7G 1T2
Phone: 613-382-8220
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