Fillable 2021-22 Request to Use Parents Estimated Income Purpose (Collège Boréal)

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2021-22 Request to Use Parents Estimated Income Purpose (Collège Boréal)

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1
June 23, 2021
2021-22
OSAP Application Update:
Request to Use Parent’s Estimated Income
Normally your parent’s 2020 income information is used when assessing your 2021-22 OSAP
Application for Full-Time Students. Use this form to request that your parent’s estimated 2021
income be used instead of their 2020 income.
You can make this request if your parent’s nancial situation changed in 2021 because of
unexpected and/or one-time circumstances, such as:
• loss of income as a result of the COVID-19 pandemic;
• loss of full-time employment and/or new employment at a lower pay rate;
• illness, accident or retirement; and/or
• receipt of a severance package, insurance settlement or other one-time income payout.
In order to complete this form, you must have already submitted a 2021-22 OSAP Application for
Full-Time Students.
Purpose
Your parent must provide documentation (e.g. letter from employer, legal documents) that supports the
circumstances that led to a change in income. An original signature is required to complete the form.
Required documents
How to submit this form
If you’re going to a school in Ontario:
Send your completed form and all required documents to your school’s nancial aid oce.
If you’re going to a school outside of Ontario:
Send your completed form and required documents to: Student Financial Assistance Branch,
Ministry of Colleges and Universities, PO Box 4500, 189 Red River Road, 4th Floor, Thunder
Bay, Ontario, P7B 6G9.
You can upload your completed form online. Log into the OSAP web site and go to your application
to use the “Print or upload documents” button. Or, you can submit a paper copy as follows:
Verication of income
The ministry veries income information provided for your application. If your parent’s 2020 income
can’t be veried with the Canada Revenue Agency (CRA), they must complete the 2021-22 Parental
Income Verication: Canadian Non-taxable and/or Foreign Income form.
If the ministry cannot verify your parent’s estimated 2021 income within 12 months from the start of
your 2021-22 study period, any Ontario Student Grant you receive will be converted to a loan that
you must repay.
Ministry of Colleges and Universities
Student Financial Assistance Branch
If your parent’s nal veried 2020 income is greater than the estimate you provide, your OSAP will
be reassessed using their actual 2020 income, and grants you have received based on the lower
estimate may be converted to loans.
2
June 23, 2021
Deadline
This form and all required documents must be received by your nancial aid oce or the ministry no
later than 40 days before the end of your 2021-22 study period.
If you’re going to a school in Ontario:
Contact the nancial aid oce at your school.
Questions?
If you’re going to a school outside Ontario:
Contact the ministry at: Student Financial Assistance Branch, Ministry of Colleges and
Universities, PO Box 4500, 189 Red River Road, 4th Floor, Thunder Bay, Ontario, P7B 6G9.
General inquiry telephone service is available Monday to Friday, 8:30 AM – 4:30 PM (Eastern
Time)
• Telephone: 807-343-7260.
• Toll-free in North America: 1-877-OSAP-411 or 1-877-672-7411
• TTY: 1-800-465-3958
2021-22
OSAP Application Update:
Request to Use Parent’s Estimated Income
Ministry of Colleges and Universities
Student Financial Assistance Branch
3
June 23, 2021
2021-22 OSAP Application Update:
Request to Use Parent’s Estimated Income
Social Insurance Number:
First name:
Ontario Education Number (OEN), if assigned to you:
Social Insurance Number:
Section A: Student’s information
Last name:
Student’s mailing address
Street number and name, rural route, or post oce box:
Apartment:
City, town, or post oce:
Province or state:
Postal code or zip code:
Area code and telephone number:
Street number and name, rural route, or post oce box:
Country:
Student’s study period details
What is the name of the school you plan to attend or are currently attending
for your 2021-22 study period?
Student number at your school:
Student’s personal information
4
June 23, 2021
2021-22 OSAP Application Update:
Request to Use Parent’s Estimated Income
Social Insurance Number:
Date:
Signature of student:
Your personal information will be used to administer and nance the Ontario Student Assistance
Program (OSAP) as set out in the notice of Collection and Use of Personal Information on your OSAP
application and in accordance with the consents you signed on your OSAP application. The Ministry
of Colleges and Universities administers and nances OSAP under the legal authority set out on
your OSAP application. If you have any questions about the collection, use and disclosure of your
personal information, contact the Director, Student Financial Assistance Branch, Ministry of Colleges
and Universities, PO Box 4500, 189 Red River Road, Thunder Bay, Ontario, P7B 6G9; 807-343-7260.
Day Month Year
• I have given complete and true information on this form.
• I understand that I am responsible for providing all required supporting documentation as
indicated on this form or as directed by my nancial aid oce or the ministry.
• I understand that if my review request is approved, my OSAP application will be reassessed
based on my parent’s estimated income provided on this form. This estimated income would
be used because non-recurring and/or unexpected circumstances have occurred and my
parent’s prior year income does not accurately reect our family’s current income situation.
• I understand that the ministry will verify my parent’s 2021 estimated income with Canada
Revenue Agency (CRA) or through other means when income information becomes
available.
• I understand that if my application is reassessed after my parent’s 2021 estimated income is
veried, it may aect my eligibility for OSAP and the type and amount of nancial assistance I
may receive.
• I understand that if the income I have reported or my parent(s) have reported cannot be
veried to the satisfaction of the Minister, the full amount of my Ontario Student Grants will be
converted to loan.
• If I received nancial assistance in excess of my entitlement, I will be responsible for the
repayment of the amount of excess nancial assistance received and I acknowledge that any
future amount of nancial assistance I am entitled to receive may be reduced by the amount
owed.
• I understand that any grants that I receive may be converted into loans if I do not meet
the terms and conditions of the Ontario Student Grants in the Ontario Student Grants and
Ontario Student Loans Regulation under the Ministry of Training, Colleges and Universities
Act and the terms and conditions of the Canada Student Grant in the Canada Student
Financial Assistance Regulations under the Canada Student Financial Assistance Act.
Student’s declaration
Note: if you are completing this form electronically, use the “Fill & Sign” feature in Adobe Reader
or your PDF program to add your signature.
5
June 23, 2021
2021-22 OSAP Application Update:
Request to Use Parent’s Estimated Income
Social Insurance Number:
Parent 1
First name:
Last name:
Social Insurance Number:
Parents must provide the following:
• If the reason for the change in income is “loss of income as a result of the COVID-19
pandemic”, provide a letter or copy of a notice of layo from their employer, or proof of
approval or receipt of government income replacement programs such as Employment
Insurance or the Canada Recovery Benet (CRB) (a copy of a statement or screenshot
showing CRB deposit is acceptable).
• For all other reasons, provide documentation conrming the circumstances indicated, such
as a letter from their employer, proof of approval or receipt of government support program
such as Ontario Works or Loss of Earnings Benets from the Workplace Safety and Insurance
Board (WSIB), legal documents, Second Career Agreement, proof of sale of property, etc.
Section B: Parent’s estimated income
Required documentation
Parent 1: Reason for change in income
Loss of income as a result of the COVID-19 pandemic
Loss of full-time employment and/or new employment at a lower pay rate
Retirement
Receipt of a severance package, insurance settlement, or other one-time income payout
Signicant change in annual income related to self-employment, (for example, farming
or any other type of self-employment where income uctuates signicantly)
Other: Provide a brief description of your circumstances below:
Illness, injury, or parental leave
Separation or divorce of parents results in change in employment of custodial parent
6
June 23, 2021
2021-22 OSAP Application Update:
Request to Use Parent’s Estimated Income
Social Insurance Number:
Estimated total income as will be reported on line 15000 of 2021 Canadian income
tax return:
Estimated Canadian non-taxable income and/or foreign income (taxable and non-taxable)
that will not be reported on parent 1’s 2021 Canadian income tax return:
$
$
Do not include non-taxable benets or refundable tax credits (e.g. Canada Child Benet,
Ontario Trillium Benet)
Parent must enter an estimate of their 2021 total income from January 1, 2021 to December 31,
2021. Enter the amount in dollars only; do not indicate cents or use periods or commas. If parent
expects to enter information on line 21000 (deduction for elected split-pension amount) on their 2021
income tax returns, subtract the amount that will be entered on line 21000 from the amount that will
be entered on line 15000 and enter this as the estimated income amount.
Parent 1 estimated 2021income
If your parent’s nal veried 2021 income is greater than the estimate you provide, your OSAP will
be reassessed using their actual 2021 income, and grants you have received based on the lower
estimate may be converted to loans.
Government income replacement programs, including Employment Insurance and the Canada
Recovery Benet are taxable income and should be included here.
7
June 23, 2021
2021-22 OSAP Application Update:
Request to Use Parent’s Estimated Income
Social Insurance Number:
Parent 2
First name:
Social Insurance Number:
Last name:
Section B: Parent’s estimated income (continued)
Parents must provide the following:
• If the reason for the change in income is “loss of income as a result of the COVID-19
pandemic”, provide a letter or copy of a notice of layo from their employer, or proof of
approval or receipt of government income replacement programs such as Employment
Insurance or the Canada Recovery Benet (CRB) (a copy of a statement or screenshot
showing CRB deposit is acceptable).
• For all other reasons, provide documentation conrming the circumstances indicated, such
as a letter from their employer, proof of approval or receipt of government support program
such as Ontario Works or Loss of Earnings Benets from the Workplace Safety and Insurance
Board (WSIB), legal documents, Second Career Agreement, proof of sale of property, etc.
Required documentation
Parent 2: Reason for change in income
Loss of income as a result of the COVID-19 pandemic
Loss of full-time employment and/or new employment at a lower pay rate
Retirement
Receipt of a severance package, insurance settlement, or other one-time income payout
Signicant change in annual income related to self-employment, (for example, farming
or any other type of self-employment where income uctuates signicantly)
Other: Provide a brief description of your circumstances below:
Illness, injury, or parental leave
Separation or divorce of parents results in change in employment of custodial parent
8
June 23, 2021
2021-22 OSAP Application Update:
Request to Use Parent’s Estimated Income
Social Insurance Number:
Estimated total income as will be reported on line 15000 of 2021 Canadian income
tax return:
Estimated Canadian non-taxable income and/or foreign income (taxable and non-taxable)
that will not be reported on parent 2’s 2021 Canadian income tax return:
$
$
Do not include non-taxable benets or refundable tax credits (e.g. Canada Child Benet,
Ontario Trillium Benet)
Parent must enter an estimate of their 2021 total income from January 1, 2021 to December 31,
2021. Enter the amount in dollars only; do not indicate cents or use periods or commas. If parent
expects to enter information on line 21000 (deduction for elected split-pension amount) on their 2021
income tax returns, subtract the amount that will be entered on line 21000 from the amount that will
be entered on line 15000 and enter this as the estimated income amount.
Parent 2 estimated 2021 income
If your parent’s nal veried 2021 income is greater than the estimate you provide, your OSAP will
be reassessed using their actual 2021 income, and grants you have received based on the lower
estimate may be converted to loans.
Government income replacement programs, including Employment Insurance and the Canada
Recovery Benet are taxable income and should be included here.
9
June 23, 2021
2021-22 OSAP Application Update:
Request to Use Parent’s Estimated Income
Social Insurance Number:
Parent’s declaration
• I have given complete and true information on this form.
• I have provided all required supporting documentation required by this form.
• I understand that if this review request is approved, my child’s OSAP application will be
reassessed based on my estimated income provided on this form. This estimated income
would be used because non-recurring and/or unexpected circumstances have occurred and
my prior year income does not accurately reect our family’s current income situation.
• I understand that the ministry will verify my 2021 estimated income with Canada Revenue
Agency (CRA) or through other means when income information becomes available.
• I understand that if my child’s application is reassessed after my 2021 estimated income
is veried, it may aect my child’s eligibility for OSAP and the type and amount of nancial
assistance my child receives. Any grants that my child receives may be converted into loans
if the reassessment results in a determination that my child is no longer eligible for the grants
or that my child is no longer entitled to the amount of the grants received.
• I understand that any Ontario Student Grants that my child receives will be converted into
loans if the 2021 estimated income I reported cannot be veried to the satisfaction of the
Minister.
Date:
Signature of parent 1:
Date:
Signature of parent 2:
Your personal information will be used to administer and nance the Ontario Student Assistance
Program (OSAP) as set out in the notice of Collection and Use of Personal Information on your child’s
OSAP application and in accordance with the consents you signed on your child’s OSAP application.
The Ministry of Colleges and Universities administers and nances OSAP under the legal authority
set out on your child’s OSAP application. If you have any questions about the collection, use and
disclosure of your personal information, contact the Director, Student Financial Assistance Branch,
Ministry of Colleges and Universities, PO Box 4500, 189 Red River Road, Thunder Bay, Ontario P7B
6G9; 807-343-7260.
Day Month Year
Day Month Year
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2021-22 Request to Use Parents Estimated Income Purpose (Collge Boral)

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Completed 25 July 2021

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