Request for Record of Employment

Details
Number INS3166
Title Request for Record of Employment
Purpose Complete this form if after requesting your Record of Employment from your last employer you are still unable to obtain it. Complete parts A, B, C and sign the form. You can mail or deliver this form to your local Service Canada Centre.
Group Employment Insurance
Paper Size 8.5x11
Important Information
Returning the Form
Forms
This site uses PDF form technology. To print these high-quality PDF forms, you must have a PDF reader installed. If you do not already have such a reader, there are several available on the Internet: Adobe Reader and Foxit Reader are popular examples.

The form(s) are available in the following formats: PDF.
PDF
To access the Portable Document Format (PDF) version you must have a PDF reader installed. If you do not already have such a reader, there are several PDF readers available on the Internet.

Request for Record of Employment
PDF, sc-ins3166(2012-01-007)e.pdf, 1103 KB, printed on 2 pages

For more information, please consult the Forms Help page.

Search for Forms