Compassionate Care Benefits Attestation

Details
Number INS5223
Title Compassionate Care Benefits Attestation
Purpose Have this form completed by the gravely ill person that considers you “like” a family member. This form should accompany your claim for compassionate care benefits. You can also mail or deliver the form to your local Service Canada Centre.
Group Employment Insurance
Paper Size 8.5x11
Important Information
Returning the Form
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Compassionate Care Benefits Attestation
PDF, sc-ins5223(2013-09-004)e.pdf, 574 KB, printed on 1 page

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