Ontario Student Opportunity Grant Canada Student Grant for ... · Check the FIRST statement that describes your current situation. Check only one box. Read and follow carefully the

Section A: Personal Information

100 Social Insurance Number: 1 105 Student number at your school:

107 Ontario Education Number (OEN) if assigned to you by the Ministry of Education:

1

If you are planning to attend a postsecondary school outside Canada, attach a photocopy of your Social Insurance Number card or a photocopy of any other

Government of Canada official document that indicates your Social Insurance Number (such as Canada Revenue Agency Notice of Assessment, Canada Pension

Plan Statement of Contributions, or a Confirmation of Social Insurance Number from Service Canada). See page 7 of the instructions for details.

110 Last name:

115 First name:

Permanent Canadian Address

A permanent Canadian address is mandatory. If you don’t have one, enter the address of a friend or relative living in Canada. You

can change your address on the OSAP website at www.ontario.ca/osap.

034 Street number and name, rural route, or post office box: 035 Apartment:

036 City, town, or post office: 037 Province:

038 Postal code (e.g., POT2EO): 039 Area code and telephone number:

Mailing Address

If you want to, give us your mailing address instead of your permanent Canadian address.

Is your mailing address the same as your permanent Canadian address? Yes

No - provide your mailing address below.

120 Street number and name, rural route, or post office box: 125 Apartment:

127 Street number and name, rural route, or post office box: 135 Province or state:

130 City, town, or post office: 140 Postal code or zip code:

137 Country: 145 Area code and telephone number:

February 2013

Ontario Student Assistance Program 2012-2013 Application for Full-Time Students

Includes funding from:

• 30% Off Ontario Tuition

• Canada-Ontario Integrated Student Loan

• Ontario Student Opportunity Grant

• Ontario Access Grants

• Ontario Access Grant for Crown Wards

• Ontario Distance Grants

• Canada Student Grant for Persons with Dependants

• Canada Student Grant for Persons from Middle-Income Families

• Canada Student Grant for Persons from Low-Income Families

• Canada Student Grant for Persons with Permanent Disabilities

OFFICE USE ONLY

090 Date received at FAO:

095 Institution Code:

Day Month Year

2012-2013 OSAP Application for Full-Time Students Social Insurance Number:

Page 2

150 In which language do you prefer to receive correspondence?

English

French

155 Date of birth:

Day Month Year

160 Gender:

Male

Female

165 Do you want to self-identify as being a student with a permanent disability? 2

Yes

Required Documentation: The Canada Student Financial Assistance Regulations require that you submit documentation to

demonstrate that you have a permanent disability. You must provide a recent medical certificate, report or assessment

(e.g., a learning disability assessment) completed by a qualified practitioner, or documentation proving that you are in

receipt of federal and /or provincial disability assistance.

No 2 Students who self-identify as being a student with a permanent disability will be automatically considered for the Canada Student Grant for Persons with

Permanent Disabilities. For the purposes of this application, “permanent disability” is defined as a functional limitation that is caused by a physical or mental

impairment that restricts your ability to perform the daily activities necessary to participate in studies at a postsecondary level or in the labour force, and that is

expected to remain with you for your expected life.

166 Are you a deaf, deafened, or hard-of-hearing student planning to attend a postsecondary school outside Canada in which the

language of instruction for your program of study is Quebec or American Sign Language (ASL)? 3

See page 19 of the instructions for details.

Yes

No 3

If your program of study is not delivered in American or Quebec Sign Language, you will be considered only for the Canada-portion of the Canada-Ontario

Integrated Student loan.

170 What is your current citizenship status?

Canadian Citizen

Permanent Resident

Required Documentation: You must provide a photocopy of your Canadian Immigration Record or of your Permanent

Resident Card.

Other

Protected Person 4

Required Documentation: You must provide a photocopy of your valid Protected Person Status Document (PPSD) and a

photocopy of your temporary Social Insurance Number (SIN) card.

4 A Protected Person is defined in subsection 95(2) of the Immigration and Refugee Protection Act (Canada). Protected Persons are individuals who have been

issued a Protected Persons Status Document and can include convention refugees and humanitarian-protected persons abroad; and persons in need of

protection. A person in need of protection is a person in Canada whose removal to their country of nationality or former habitual residence will make them

subject to the possibility of torture, risk of life, or risk of cruel and unusual treatment or punishment. Go to the OSAP website, at www.ontario.ca/osap, for

details.

175 When did you last attend a high school on a full-time basis? 5

Month Year

5 A full-time high school student is a student taking 60% or more of a regular high school program. If you left high school at any time and were out of high

school for at least one full year, the date you last attended high school on a full-time basis is the date when you first left high school.


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180 Have you ever taken full-time postsecondary studies? 6

Yes - complete item 185.

No

185 When did you last take full-time studies?

Month Year

6 “Full-time postsecondary studies” means at least 60% of a full course load, or at least 40% if you are a student with a permanent disability.

190 Have you ever had a student loan from Canada or Ontario?

Yes

No

610 Have you ever filed for bankruptcy or initiated a related event ? 7

Yes - complete items 611 and 612.

No

7 If you initiated a bankruptcy or a related event, this means you have made a consumer proposal under the Bankruptcy and Insolvency Act (BIA) that is

approved or deemed to be approved by a court under that Act, obtained a consolidation order under the BIA, filed for bankruptcy under the Bankruptcy and

Insolvency Act (Canada) (BIA), or filed a document seeking relief for the orderly payment of debts. Refer to page 8 of the Instructions for details about

bankruptcy and related events.

611 Are you an undischarged bankrupt? 8

Yes

Required documentation: See page 8 of the Instructions for complete details.

No

612 What is the date you filed for bankruptcy or initiated a related event? 7

Day Month Year

8 Definition of an undischarged bankrupt - You are an undischarged bankrupt if you filed for bankruptcy and that process has not been completed,

withdrawn, annulled, or you did not obtain an absolute order of discharge from the court.

615 Where will you be living during most of the 16-week period before your 2012-2013 study period starts? 9

With parent(s)

Other

9 If you are a dependent student, you will be assessed as living with your parent(s) during the pre-study period. If you did not live with your parent(s) during the

pre-study period, please contact your financial aid office. Seen page 15 of the Instructions for details.

797 Were you ever a Crown Ward? 10

Yes

No

10 A Crown ward is a child who has been made a ward of the Crown pursuant to a court order made under the Child and Family Services Act, R.S.O. 1990, c.

C.11. See page 12 of the Instructions for details.


Page 4

Section B: Current Status Information Check the FIRST statement that describes your current situation. Check only one box. Read and follow carefully the instructions that

pertain to that statement. Supporting documentation is required for items 200, 210, 221, 231, 260, and 265. See the instructions

booklet for a list of acceptable documentation.

I am married. 11

Go to Section C, Part 1. Your spouse must also fill out Section J and M. 11

For OSAP purposes, your “spouse” is the person to whom you are married or the person with whom you are living in a common-law relationship.

I am in a common-law relationship. 12

Go to Section C, Part 1. Your spouse must also fill out Section J and M. 12

For OSAP purposes, you are living in a common-law relationship if (a) you and your spouse have been living together in a conjugal relationship for not

less than 3 years, or (b) you and your spouse are living together in a conjugal relationship and raising any children of whom you both are the natural or

adoptive parents.

I am a sole-support parent. 13

Complete item 221 and then go to Section C, Part 2. 13

For OSAP purposes, you are a sole-support parent if you have any dependent children living with you on a full-time basis during your study period,

AND you are single, separated, divorced or widowed.

221 What is your marital status?

Separated

Divorced

Widowed

Never Married

I am separated, divorced, or widowed, AND I have NO dependent children living with me.

Complete item 231 and then go to Section C, Part 2.

231 What is your marital status?

Separated

Divorced

Widowed

None of the above statements applies to me and I have been out of high school for at least 4 years as of the start of

my 2012-2013 study period.

Go to Section C, Part 2.

None of the above statements applies to me and both of the following statements are true:

• I have NOT been a full-time high school student at a high school for at least 12 months in a row on 2 or more

occasions.

• I have NOT been a full-time postsecondary student for at least 12 months in a row on 2 or more occasions.


None of the above statements applies to me and at least one of these statements is true:

• I am receiving Extended Care and Maintenance Allowance.

• I am currently a Crown ward.

• I was a Crown ward at the time of my 18th birthday. 14

Go to Section C, Part 2. 14

See page 12 of the Instructions booklet for a definition of a crown ward

None of the above statements applies to me and BOTH of my parents are deceased.


None of the above statements applies to me.

Go to Section C, Part 3. Your parent(s) must also fill out Sections I and L.

200

210

220

230

240

250

260

265

270


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Section C: Residency Information Based on the item you checked in Section B, check the ONE statement below that BEST describes your current residency situation.

Part 1 - If you checked item 200 or 210 in Section B, check the ONE statement that best describes your current residency situation:

I have always resided in Ontario.

Ontario is the last province in which I resided for 12 months in a row without being a full-time postsecondary student.

My spouse has always resided in Ontario.

Ontario is the last province in which my spouse resided for 12 months in a row without being a full-time postsecondary

student.

I reside in Ontario, AND my spouse and I have resided in Canada for less than 12 months in a row. 15

15

If you are enrolled or are planning to enrol in a postsecondary school in Ontario, you must complete the applicable “History of Canadian Residency”

form in order for the ministry to determine if you are a resident of Ontario for OSAP purposes. You are not a resident of Ontario for OSAP purposes if

you are enrolled or are planning to enrol in a postsecondary school outside Ontario. You should contact that province’s or territory’s student

assistance program to apply for assistance. See instructions booklet for details. The “History of Canadian Residency” form is available for printing from

the OSAP website, at www.ontario.ca/osap.

All of the following statements are true:

• I now reside in Ontario.

• I have resided in Canada for less than 12 months in a row.

• My spouse has resided in Canada for less than 12 months in a row. 16

Required Documentation: A detailed description of your and/or your parent(s)’ or spouse’s (if applicable) residency

history in Canada and any relevant documentation. If you or your parent(s) or spouse (if applicable) have lived in another

Canadian province or territory for 12 months in a row, you must also provide a letter regarding your eligibility for its

Program from the student assistance program in the province or territory in which you resided. 16 You are not a resident of Ontario for OSAP purposes. If you, and/or your parent(s) or spouse (if applicable) have resided in another Canadian

province or territory for 12 months in a row (excluding time you or your spouse spent in full-time postsecondary studies), you must contact that

province’s or territory’s student assistance program to determine if you are eligible for assistance. If, according to that province’s or territory’s

residency requirements, you are not eligible for assistance, you may be considered for OSAP funding if you provide documentation.

Part 2 - If you checked item 220, 230, 240, 250, 260, or 265 in Section B, check the ONE statement that best describes your current

residency situation:



I now reside in Ontario AND I have resided in Canada for less than 12 months in a row. 15

I now reside in Ontario but none of the above statements applies to me. 16

Part 3 - If you checked item 270 in Section B, check the ONE statement that best describes your current residency situation:



Ontario is the last province in which my parent(s) have resided for 12 months in a row.

I reside in Ontario, AND my parent(s) and I have resided in Canada for at least 12 months in a row. 15

I now reside in Ontario, but none of the above statements applies to me. 16

300

305

310

330

315

325

300

305

330

325

300

305

320

330

325


Page 6

Section D: Information on Your School and Program

500 What is the name of the school you plan to attend (e.g., York University)?

505 Which campus of the above school will you be attending, if applicable (e.g., Glendon College)?

510 In which city or town is the above school located? If the school is located outside Canada, please also specify the country.

What is the address of the school you plan to attend?

Street number and name, rural route, or post office box:

City, town, or post office:

Country:

Province: Postal code:

515 What is the name of your program (e.g., Business Accounting, Chemical Engineering)?

520 What are the start and end dates of your 2012-2013 study period?

From To

Month Year Month Year

525 What is your level of study?

Diploma

Certificate

Bachelor’s degree

Master’s degree

Doctoral degree

Other

530 Which year of your program will you be entering (e.g., year 1, year 2)?

535 What is the total number of years in your program (e.g., 3 years, 4 years)?

540 Are you taking a cooperative (co-op) education program?

Yes

No


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545 What percentage of a full course load will you be taking? 17

17 You can apply if you are a full-time student. You are a full-time student if you are taking at least 60% of a full course load. A person with a permanent

disability is a full-time student if he or she is taking at least 40% of a full course load. See page 12 of the Instructions booklet for a definition of “permanent

disability”.

550 Are you taking your program of study through correspondence or distance education?

Yes

No

50

555 Will you be living with your parent(s) during your 2012-2013 study period?

Yes

No

560 What is the cost of one return trip, by the most economical means available, from your school to your permanent Canadian

address? 18

18 Complete this item only if you checked item 270 in Section B.

Section E: Student’s Vehicles and Assets Provide the value of all of your vehicles and assets, world-wide (and the world-wide assets of your spouse, if applicable), as of the 16

weeks before the start of your 2012-2013 study period start date. This date is known as your asset validation date. Enter amounts

in dollars only; do not indicate cents.

655 Do you have a valid, expired, cancelled or suspended Ontario driver’s licence?

Yes – complete item 656.

No

656 What is your Ontario driver’s licence number?

638 Do you (and your spouse, if applicable) currently own or lease vehicles?

Yes - complete items 639 to 693.

No

639 How many vehicles do you (and your spouse, if applicable) currently own or lease?

Vehicle Details

For the vehicles listed in item 639, enter the make and model, licence plate number, year, and current gross market value in items

640 to 693. If you require more space, you must provide the information requested below in a separate letter and attach it to this

application. All vehicle information will be verified with the registering agency. Enter amounts in dollars only. Do not enter cents or

use periods or commas.

First Vehicle

640 Make and model

641 Licence plate number

642 Year 643 Gross market value


Page 8

Second Vehicle

650 Make and model



Third Vehicle

680 Make and model



Fourth Vehicle

690 Make and model



Assets

660 What is the total net value of your RRSPs? 19

19

The total net value of RRSPs is the current market value (principal and interest) of all RRSP accounts less: a) funds (principal and interest) inaccessible under

the Canada Pension Act; b) the balance owing (at asset valuation date) of any loans taken out specifically to purchase an RRSP; c) any financial penalties

assigned by the financial institution and/or d) income tax withheld by a financial institution.

670 What is the total gross value of your other assets? 20

20

Indicate the total gross value of all account balances at financial institutions, bonds, term deposits, GICs, all other investments, and any other assets (e.g., any

real estate other than your principal residence, boats, aircraft) not indicated in items 640 to 693 and 660. DO NOT INCLUDE the value of your principal

residence, clothing, furniture, personal belongings, non-economic loss and/or pain and suffering awards of less than $100,000, RESPs that have not been

cashed in and/or savings through the Ontario Child Benefit Equivalent.


Page 9

Section F: Student’s Income Income information provided on this page must include all taxable and non-taxable income from all sources, world-wide.

Include employment income, child-support and alimony payments, monetary gifts, lottery winnings, and government benefits,

cashed-in RRSPs, cashed-in RESPs, withdrawals from retirement accounts and trust accounts, income received as a result of a joint

election to split pension income, the amount of non-economic loss and/or pain and suffering awards in excess of $100,000, and any

other income (e.g., awards, scholarships, fellowships, bursaries, grants, interest, investments, and/or trust fund income).

Do not include money received through HST/GST Rebates, Canada Child Tax Benefit, Universal Child Care Benefit, Ontario Child

Benefit, Ontario Children Benefit Equivalent Savings Program, the Rental Opportunity for Ontario Families (ROOF) Program, the

Extended Care and Maintenance Allowances, and OSAP funding, including student loans, 30% Off Ontario Tuition, Queen Elizabeth II

Aiming for the Top Scholarships, Canada Student Grants, Ontario Access Grants, Ontario Student Opportunity Grants, Distance

Grants, and Transition Grants.

Do not include an award, bursary, and/or a needs-based scholarship from an Ontario public college or university, if that

postsecondary institution informs you in writing that they will report it to OSAP directly. If you have not received notification in

writing from your postsecondary institution, then you must report this income.

The ministry will verify whether you receive income from any other ministry programs. The ministry may also verify your income by

contacting persons or bodies, including government bodies within and outside of Canada, that administer any form of financial

assistance, including but not limited to the income supports identified in item 630 and that may have information about any sources

of your income. See page 16 of the instructions for important information on verification and audit.

665 The ministry may use a portion of your OSAP funding to pay, on your behalf, your tuition and compulsory fees directly to

your school. If you don’t want the fees to be paid on your behalf, indicate so here.

Don’t pay fees on my behalf

Income Received During 2011

Enter amounts in dollars only. Do not enter cents or use periods or commas. If the amount is not applicable or negative, enter (0).

635 Enter your total gross income as indicated on line 150 of your 2011 Canadian income tax return.

If you have not filed a 2011 Canadian income tax return, enter the amount you expect to report. 21

21

If you checked item 200, 210, 220 or 230 in Section B and if you entered data in line 117 and/or 210 of your 2011 Canadian Income Tax Return, then subtract the

amount entered in line 117 and/or 210 from the amount entered in line 150. Enter the revised amount in item 635.

Income Received During 2012


636 Enter an estimate of the total gross income from all sources that you expect to receive from

January 1, 2012 to December 31, 2012.

637 Enter an estimate of the total gross income from all sources that you expect to receive from

January 1, 2012 to the start date of your pre-study period. 22 23

22

To determine the date on which your pre-study period starts, subtract the number of weeks in your pre-study period (see definition below) from the starting date of

your 2012-2013 study period (as reported in item 520 in Section D).

23 Definition of pre-study period : If you were a full-time high school or postsecondary student in 2011-2012, your pre-study period is the time between the end of your

last period of study and the start of your 2012-2013 study period. If there are more than 16 weeks between these two periods, enter the income received in the 16 weeks immediately before the start of your 2012-2013 study period. If there are fewer than 16 weeks between these two periods, enter the income received during the actual number of weeks between these two periods. If you were not a full-time high school or postsecondary student last year, your pre-study period is the 16 weeks immediately before the start of your 2012-2013 period of study.


Page 10

Income Received Before the Start of Your 2012-2013 Study Period


600 Enter an estimate of the total gross income from all sources that you expect to receive during your pre-study period.

Exclude any amounts that you expect to receive from Ontario Disability Support Program or Ontario Works.

24 Do not include an award, bursary, and/or a needs-based scholarship received from a public Ontario college or university if that postsecondary school informs you in

writing that they will report the award to OSAP directly. If you have not received notification in writing from your postsecondary school, then you must report this income in Item 600 and/or 626, as indicated.

601 Enter an estimate of the amount you expect to receive from Ontario Disability Support Program or Ontario Works in your pre-study

period. 24

605 If you entered an amount in Item 601, indicate the type of Ontario social assistance you will be receiving during your

pre-study period.

Ontario Disability Support Program

Ontario Works during the pre-study period.

Income Received During Your 2012-2013 Study Period


625 Government income you expect to receive during your study period: 25

25 If you are a dependent adult participant in an Ontario Disability Support Program or Ontario Works Program, do not include the income support that your parents

expect to receive for you.

626 Scholarships, bursaries, and awards you expect to receive during your study period: 24

661 Registered Education Savings Plan (RESP), Scholarship Trust Fund, or other education savings plan you intend to use for your

study period:

620 Employment income you expect to receive during your study period: Do not include study period income already provided above for this time period.

630 If you entered income in item 625, indicate the type of government income you expect to receive:

Employment Insurance

Loss of Earnings Benefits (WSIB)


Ontario Works

Native Postsecondary Student Support Program

Canada Pension Plan (Orphans' Benefits, Survivors' Benefits, Disabled Contributors' Child's Benefits)

Second Career

Ontario Skills Development

Other (Specify)


Page 11

Section G: Information on Student’s Children You must complete this section if you have any dependent children living full-time with you (and your spouse, if applicable) during your

study period. Complete this section only if you checked item 200, 210, or 220 in Section B.

How many dependent children (e.g., 1, 2, 3) in each age group will be living full-time with you (and your spouse, if applicable)

during your 2012-2013 study period?

400 0–11 years of age:

410 12 years of age or older who do not have a disability:

411 12 years of age or older who have a disability:

405 For the children in items 400 and 411, what is the TOTAL amount that you expect to pay for child care during your

2012-2013 study period?

Children Details

For each of your dependent children 0–11 years of age and for each of your dependent children 12 years of age or older who has a

disability, enter the child’s first name, last name, date of birth and the amount you expect to pay for child care. If you require more

space, you must provide the information requested below in a separate letter and attach it to this application. In addition, you must

attach to this application proof of each child’s date of birth. Proof may include a copy of a child’s Birth Certificate, a Statement of

Live Birth, a Government of Canada’s Child Tax Benefit cheque stub or statement (must contain name and date of birth of each

child), or a copy of a baptismal certificate.

Provide details for children who are 0-11 years of age. If you have a child who has a disability and is over 12 years of age include

details for that child too.

Child 1

730 First name:

731 Last name:

732 Date of birth:

Day Month Year

733 For this child, indicate the amount that you expect to pay for child care during your 2012-2013 study period:

Child 2

735 First name:

736 Last name:

737 Date of birth:

Day Month Year


Page 12


Child 3

740 First name:

741 Last name:

742 Date of birth:

Day Month Year


Child 4

745 First name:

746 Last name:

747 Date of birth:

Day Month Year


Child 5

750 First name:

751 Last name:

752 Date of birth:

Day Month Year



Page 13

Child 6

755 First name:

756 Last name:

757 Date of birth:

Day Month Year


Child 7

760 First name:

761 Last name:

762 Date of birth:

Day Month Year


Section H: Information Required for Grant Consideration If you checked items 200, 210, 220, 230,240, 250 or 260 in Section B, you may be eligible for a 30% Off Ontario Tuition Grant and/or

Ontario Access Grant. If you want to be considered, we need information from your parent(s).

010 You may be eligible for a 30% Off Ontario Tuition Grant and/or Ontario Access Grant but we need information from your

parent(s). Do you want to provide that information? Yes – complete items 027.

No

027 Were you a Crown ward at the time of your 18th birthday?

Yes – You will be automatically considered for the Ontario Access Grant and 30% Off Ontario Tuition. No parental

information is required.

No – complete item 011.

011 Are both your parents deceased? Yes – You will be automatically considered for the Ontario Access Grant and 30% Off Ontario Tuition. No parental

information is required.

No – complete item 028.


Page 14

Parent Status

028 My parents are married to each other or are in a common-law relationship with each other:

Yes - both parents must complete Parent 1 and Parent 2 Details in Section I and L.

No - complete section I.

029 The parent that I currently live with has remarried or is in a common-law relationship:

If you moved to go to school, base your response on the parent you lived with before moving away.

Yes - The parent you currently live with (or lived with before moving) and his or her spouse or common-law partner

must complete Parent 1 and Parent 2 Details in Section I and L.

No - The parent you currently live with (or lived with before moving) must complete Parent 1 Details in Section I and L.

Also complete item 030.

030 What is the marital status of your parent?

Divorced

Separated

Widowed

Single

Section I: Information from Parents If you checked item 270 in Section B, your parent(s), step-parent, legal guardian(s), or official sponsor(s) must complete this section.

This section may also be completed depending upon your answers in Section H.

Marital Status

Are your birth or adoptive parents still married or in a common-law relationship with each other?

Yes - both parents must complete this section and sign Section L.

No - complete item 800.

800 Parent(s) you live with, or last lived with is:

Married, remarried, or in a common-law relationship 26

– both parents must complete this section and sign Section P.

Divorced

Separated

Widowed

Single

26 For OSAP purposes, a common-law relationship exists if (a) your parents or the parent you live with, or last lived with and his or her spouse have been living

together in a conjugal relationship for not less than three (3) years, or (b) your parents or the parent you live with, or last lived with, and his or her spouse are

living together in a conjugal relationship and raising any children of whom they are the natural or adoptive parents.

Parents’ Children

805 How many dependent children, including the student, do the parent(s) who are completing this section have (e.g., 1, 2, 3)? 27

815 How many of the dependent children, including the student, reported in item 805 are taking postsecondary studies (e.g., 1, 2, 3)?

27

27

For OSAP purposes, a dependent child is a child who meets one of the following criteria:

• is under 16 years of age and will be living with the parent and his or her spouse (if applicable) for 50% or more of the student’s period of study, or

• is 16 years of age or over and

- is enrolled in high school and taking at least 60% of a full course load and will be living with the parent and his or her spouse (if applicable) for 50% of the student’s

period of study;

- is a full-time postsecondary student and has been out of high school less than four years; or

- has a permanent disability and is wholly dependent on the parent (and his or her spouse, if applicable).

provide details for the parent you live with in Parent 1 section below and sign Section P.


Page 15

Parent 1 Details

830 Does Parent 1 have a Social Insurance Number?


No

820 Parent 1 Social Insurance Number:

834 Parent 1 date of birth:

Day Month Year

833 Parent 1 postal code:

821 Is Parent 1’s home within 40 km of postsecondary school the student plans to attend in the 2012-2013 academic year?

Yes

No

823 Is Parent 1 self-employed?

Yes

No

Income Reported on 2011 Canadian Income Tax Return

Enter amounts from your parent's 2011 Canadian Income Tax Return. If it has not been filed for 2011, estimate the amounts. Enter

amounts in dollars only. Do not indicate cents or use commas or periods. If the amount is zero or negative, enter zero (0). Do not

include money received through HST/GST Rebates, Child Tax Benefit, Universal Child Care Benefit, Ontario Child Benefit, Ontario

Child Benefit Equivalent Program, the Rental Opportunity for Ontario Families (ROOF) Program, or the Extended Care and

Maintenance Allowances.

840 What is Parent 1’s total income as indicated on line 150:

If parent entered data on line 210 of his or her 2011 Canadian Income Tax Return, subtract the amount entered in line 210 from

the amount in line 150. Enter the revised amount in this item.

841 What is Parent 1’s net income as indicated on line 236:

860 Does parent receive assistance from Ontario Disability Support Program or Ontario Works?


Ontario Works

870 What is Parent 1’s Canada Pension Plan contribution as indicated on lines 308 and 310:

880 What is Parent 1’s Employment Insurance premiums as indicated on line 312:

890 What is Parent 1’s total tax payable as indicated on line 435:

If parent entered data on line 421 and/or 422 on his or her 2011 Canadian Income Tax Return, subtract the amount(s) from line

435. Enter the revised amount in this item.


Page 16

Other Income

If your parent has other income not reported on his or her 2011 Canadian Income Tax Return or other income that he or she does

not expect to report, enter the TOTAL value of all taxable and non-taxable 2011 income from all sources world-wide. Enter amounts

in dollars only. Do not indicate cents or use commas or periods. If the amount is zero or negative, enter zero (0).

850 Total value of all taxable and non-taxable 2011 income from all sources world-wide.

Parent 2 Details

835 Does Parent 2 have a Social Insurance Number?


No

825 Parent 2 Social Insurance Number:

839 Parent 2 date of birth:

Day Month Year

838 Parent 2 postal code:

822 Is Parent 2’s home within 40 km of postsecondary school the student plans to attend in the 2012-2013 academic year?

Yes

No

824 Is Parent 2 self-employed?

Yes

No

Income Reported on 2011 Canadian Income Tax Return

Enter amounts from your parent's 2011 Canadian Income Tax Return. If it has not been filed for 2011, estimate the amounts. Enter

amounts in dollars only. Do not indicate cents or use commas or periods. If the amount is zero or negative, enter zero (0). Do not

include money received through HST/GST Rebates, Child Tax Benefit, Universal Child Care Benefit, Ontario Child Benefit, Ontario

Child Benefit Equivalent Program, the Rental Opportunity for Ontario Families (ROOF) Program, or the Extended Care and


845 Parent 2 total income as indicated on line 150:

If parent entered data on line 210 of his or her 2011 Canadian Income Tax Return, subtract the amount entered in line 210 from

the amount in line 150. Enter the revised amount in this item.

846 Parent 2 net income as indicated on line 236:

860 Does parent receive assistance from Ontario Disability Support Program or Ontario Works?


Ontario Works

875 Parent 2 Canada Pension Plan contribution as indicated on lines 308 and 310:

return?


Page 17

885 Parent 2 Employment Insurance premiums as indicated on line 312:

895 Parent 2 total tax payable as indicated on line 435:

If parent entered data on line 421 and/or 422 on his or her 2011 Canadian Income Tax Return, subtract the amount(s) from line


Other Income

If your parent has other income not reported on his or her 2011 Canadian Income Tax Return or other income that he or she does

not expect to report, enter the TOTAL value of all taxable and non-taxable 2011 income from all sources world-wide. Enter amounts

in dollars only. Do not indicate cents or use commas or periods. If the amount is zero or negative, enter zero (0).

855 Total value of all other taxable and non-taxable 2011 income from all sources world-wide.

Section J: Information from Spouse This section must be completed by your spouse if item 200 or 210 in Section B applies to you.

900 Spouse’s last name:

905 Spouse’s first name:

902 Spouse’s postal code:

903 Spouse’s date of birth:

Day Month Year

915 Does spouse have a Social Insurance Number (SIN)?


No

910 What is spouse’s Social Insurance Number?

215 What is the date of your marriage, or if you are in a common-law relationship, when did you begin living together in a

conjugal relationship?

Day Month Year

916 Does your spouse have a valid, expired, cancelled or suspended Ontario driver's licence?


No

917 What is spouse’s Ontario driver’s licence number?


Page 18

925 What will spouse’s status be at the beginning of applicant’s 2012-2013 study period?

Taking full-time postsecondary studies – if spouse is a full-time student complete item 935 and 940.

Employed

Other (Specify)

935 Is your spouse's program 12 weeks or more in length?

Yes

No

940 What is the name of the postsecondary school your spouse will be attending?

945 When did spouse last attend high school on a full-time basis?

Month Year

Total Income

Enter amounts from your spouse's 2011 Canadian Income Tax Return. If it has not been filed for 2011, estimate the amounts. Enter

amounts in dollars only. Do not enter cents or use periods or commas. If the amount is not applicable or negative, enter zero (0).

Do not include money received through HST/GST Rebates, Child Tax Benefit, Universal Child Care Benefit, Ontario Child Benefit,

Ontario Child Benefit Equivalent Program, the Rental Opportunity for Ontario Families (ROOF) Program, or the Extended Care and


950 Spouse’s total income as indicated on line 150:

If your spouse entered data on line 210 of his or her 2011 Canadian Income Tax Return, subtract the amount entered in line 210

from the amount in line 150. Enter the revised amount in this item.

955 Does spouse receive assistance from Ontario Disability Support Program or Ontario Works?


Ontario Works

Other 2011 Income

If the spouse did not file a 2011 Canadian Income Tax Return and/or other income not indicated on his or her return, enter the total

value of all other taxable and non-taxable 2011 income from all sources, world-wide. Enter amounts in dollars only. Do not enter

cents or use periods or commas. If the amount is not applicable or negative, enter zero (0).

951 TOTAL value of other taxable and non-taxable 2011 income from all sources world wide:

Non-refundable Tax Credits and Tax Payable

952 Spouse’s Canada Pension Plan contribution as indicated on lines 308 and 310:

953 Spouse’s Employment Insurance premiums as indicated on lines 312:

954 Spouse’s total tax payable as indicated on line 435:

If spouse entered data on line 421 and/or 422 on his or her 2011 Canadian Income Tax Return, subtract the amount(s) from line



Page 19

Section K: Sharing Your Information Do you want someone else to have access to your information (e.g., call on your behalf)?

Yes - provide details below.

No

Individual 1

700 Last name:

705 First name:

706 Date of birth:

Individual 2

710 Last name:

715 First name:

716 Date of birth:

Section L: Consents, Declarations and Signature of Parents(s) Collection and Use of Personal Information Your personal information, including your Social Insurance Number (SIN), provided in connection with the applicant’s application and award of financial assistance, including previous applications and awards of financial assistance, will be used by the Ministry of Training, Colleges and Universities (ministry) to administer and finance the Ontario Student Assistance Program (OSAP) and the Ontario Tuition Grant (OTG) and by Human Resources and Social Development Canada (HRSDC) to administer and finance the Canada Student Loans Program (CSLP). The ministry and HRSDC may use other parties for any of these activities. Under agreement with HRSDC, the National Student Loans Service Centre (NSLSC) uses your personal information to administer OSAP and CSLP. Under agreement with the ministry, the applicant’s postsecondary school and, where authorized by the ministry, its agents who administer OSAP and its auditors, use your personal information to administer OSAP and CSLP. Administration includes: determining eligibility for financial assistance; verifying this application, including verifying financial assistance provided under any other ministry program; paying the applicant’s financial assistance; verifying the applicant’s financial assistance and any relief granted from any payment the applicant is required to make; considering any applications for review or appeals of determinations relating to financial assistance or eligibility for relief from any payment; auditing the applicant’s fi le; assessing and collecting loans, overpayments, and repayments; enforcing the legislation set out below and the applicant’s agreements with the ministry, the Ontario Student Loan Trust and HRSDC; and monitoring and auditing the NSLSC and the applicant’s postsecondary school or its authorized agents to ensure that they are administering the programs appropriately. In addition, administration by the ministry and HRSDC includes public reporting on the administration and financing of student assistance programs and accessibility to postsecondary education; planning, delivering, evaluating and monitoring student assistance programs for quality and improvements in both content and delivery; conducting risk management, error management, audit and quality assessment activities; conducting inspections or investigations; and conducting policy analysis, evaluation, and research related to all aspects of student assistance programs and accessibility to postsecondary education, including developing key performance indicators about the applicant’s postsecondary school such as the aggregated Ontario Student Loan default rates of its students and establishing and monitoring the minimum amount of student aid your postsecondary school is required to provide under the Student Access Guarantee. You may be contacted to participate in surveys related to student assistance programs and accessibility to postsecondary education. Financing includes: planning, arranging, or providing funding of the programs.

Consent of Parents to the Indirect Collection and Disclosure of Personal Information (REQUIRED) • The ministry collects your personal information under the authority of the Ministry of Training, Colleges and Universities Act, R.R.O. 1990, Reg.

773, Reg. 774, and Reg. 775, O. Reg. 268/01 and O. Reg. 118/07; s. 10.1 of the Financial Administration Act; the Canada Student Financial Assistance Act, S.C. 1994, c. 28, as amended, the Canada Student Financial Assistance Regulations, SOR 95-329, as amended and s. 266.3(4) of the Education Act. If you have any questions about the collection or use of this information, contact the Director, Student Financial Assistance Branch, Ministry of Training, Colleges and Universities, PO Box 4500, 189 Red River Road, 4th Floor, Thunder Bay, ON P7B 6G9; (807) 343-7260.


Page 20

• I understand that the information on this form, including my residency history provided by the applicant, is a necessary part of the calculation of any financial assistance to the applicant. The information I have given is complete and true, and I will notify the applicant’s financial aid office or the ministry in writing if there are any changes. I agree that the ministry may use my personal information for the administration and enforcement of an OSAP or OTG application that may be made by me, my spouse and/or any other dependent children.

• I agree that until the applicant’s loans, overpayments, and repayments are assessed and repaid, the ministry can, without limitation, collect and exchange personal information about me that is relevant to the administration and financing of OSAP, OTG and CSLP with: the applicant; HRSDC; Canada Revenue Agency (CRA); NSLSC; the applicant’s postsecondary school and its authorized auditors and financial administration agents; bodies identified on this application by name or bodies that administer programs identified on this application; persons or bodies, including government bodies within and outside Canada, that may have information about my sources of income or residency; other parties used by the ministry to administer and finance OSAP and OTG;

• HRSDC’s contractors and auditors; and collection agencies operated or retained by the federal or provincial governments. • I have advised my dependants who are 16 years of age or older that I have provided limited personal information about them on this

application. I have shown them this section and I have obtained their consent to the disclosure and use of their limited personal information for the administration and financing of OSAP.

• I understand that the applicant can gain access to the personal information I provide in connection with this application. Other personal information relevant to a reassessment or appeal will be disclosed to the applicant and any person(s) authorized by the applicant to have access to all information in the applicant’s 2012-2013 OSAP fi le.

• I understand that I can withdraw any consent I have given by writing to the Director, Student Financial Assistance Branch, Ministry of Training, Colleges and Universities, PO BOX 4500, 189 Red River Road, 4th Floor, Thunder Bay, ON P7B 6G9, at any time before the applicant accepts financial assistance. I understand that if I withdraw any consent it will affect the applicant’s eligibility for and the type and amount of OSAP assistance.

I have read and understood all parts of this section, including the Collection and Use of Personal Information and my consents to the indirect

collection, use and disclosure of my personal information.

Parent 1

831 Parent 1 last name:

832 Parent 1 first name:

833 Parent 1 Signature Date

Day Month Year

Parent 2

836 Parent 2 last name:

837 Parent 2 first name:

838 Parent 2 Signature Date

Day Month Year

Consent of Parents to the Indirect Collection and Disclosure of Information from Income Tax Returns (REQUIRED) • I authorize the Canada Revenue Agency (CRA) to release to the ministry, or an authorized third party administrator as identified by the ministry,

information from my income tax returns and, if applicable, other required taxpayer information about me (“the information”), whether supplied by me or by a third party. The information will be relevant to, and used solely for the purpose of the administration and enforcement of OSAP and OTG. The ministry will not disclose the information to any person or organization except to the applicant or where authorized by or where required by law. The ministry administers OSAP under the authority of the Ministry of Training, Colleges and Universities Act, and R.R.O. 1990, Reg. 773, Reg. 774, and Reg. 775, O. Reg. 268/01 and O. Reg. 118/07; s.10.1 of the Financial Administration Act; the Canada Student Financial Assistance Act, S.C. 1994, c. 28, as amended and the Canada Student Financial Assistance Regulations, SOR 95-329, as amended and s. 266.3(4) of the Education Act. This consent applies to the 2011 and 2012 taxation years.

898 Signature of Parent 1 Date

Day Month Year

899 Signature of Parent 2 Date

Day Month Year


Page 21

Section M: Consents, Declarations and Signature of Spouse Collection and Use of Personal Information Your personal information, including your Social Insurance Number (SIN), provided in connection with this application and in all other communications related to your spouse’s application and award of financial assistance, including previous applications and awards of financial assistance, will be used by the Ministry of Training, Colleges and Universities (ministry) to administer and finance the Ontario Student Assistance Program (OSAP), by Human Resources and Social Development Canada (HRSDC) to administer and finance the Canada Student Loans Program (CSLP). The ministry and HRSDC may use other parties for any of these activities. Under agreement with the ministry and HRSDC, the National Student Loans Service Centre (NSLSC) uses your personal information to administer OSAP and CSLP. Under agreement with the ministry, your spouse’s postsecondary school and, where authorized by the ministry, its agents who administer OSAP and its auditors use your personal information to administer OSAP and CSLP. Administration includes: determining eligibility for financial assistance; verifying this application; paying your spouse’s financial assistance; verifying your spouse’s financial assistance and any relief granted from any payment your spouse is required to make; considering any applications for review or appeals of determinations relating to financial assistance or eligibility for relief from any payment; maintaining and auditing your spouse’s fi le; assessing and collecting loans, overpayments, and repayments; enforcing the legislation set out below and your spouse’s agreements with the ministry, the Ontario Student Loan Trust and HRSDC; and monitoring and auditing the NSLSC and your spouse’s postsecondary school or its authorized agents to ensure that they are administering the programs appropriately. In addition, administration by the ministry and HRSDC includes public reporting on the administration and financing of student assistance programs and accessibility to postsecondary education; planning, delivering, evaluating and monitoring student assistance programs for quality and improvements in both content and delivery; conducting risk management, error management, audit and quality assessment activities; conducting inspections or investigations; and conducting policy analysis, evaluation, and research related to all aspects of student assistance programs and accessibility to postsecondary education, including developing key performance indicators about your spouse’s postsecondary school such as the aggregated Ontario Student Loan default rates of its students and establishing and monitoring the minimum amount of student aid your postsecondary school is required to provide under the Student Access Guarantee. You may be contacted to participate in surveys related to student assistance programs and accessibility to postsecondary education. Financing includes: planning, arranging, or providing funding of the programs. The ministry collects your personal information under the authority of the Ministry of Training, Colleges and Universities Act, R.R.O. 1990, Reg. 773, Reg. 774, and Reg. 775, O. Reg. 268/01 and O. Reg. 118/07; s. 10.1 of the Financial Administration Act; the Canada Student Financial Assistance Act, S.C. 1994, c. 28, as amended; and the Canada Student Financial Assistance Regulations, SOR 95-329, as amended and s. 266.3(4) of the Education Act. If you have any questions about the collection or use of this information, contact the Director, Student Financial Assistance Branch, Ministry of Training, Colleges and Universities, PO Box 4500, 189 Red River Road, 4th Floor, Thunder Bay, ON P7B 6G9; (807) 343-7260.

Spouse’s Consent to the Indirect Collection and Disclosure of Personal Information (REQUIRED) • I understand that the information on this form, including my residency history provided by my spouse, is a necessary part of the calculation of

any financial assistance to my spouse. The information I have given is complete and true and I will notify my spouse’s financial aid office or the ministry in writing if there are any changes. I agree that the ministry may use my personal information for the administration and enforcement of an OSAP application that I made or will make or is made or will be made by any of my dependent children.

• I agree that until my spouse’s loans, overpayments, and repayments are assessed and repaid, the ministry can, without limitation, collect and exchange personal information about me that is relevant to the administration and financing of OSAP, OTG and CSLP with: my spouse; HRSDC; Canada Revenue Agency (CRA); NSLSC; my spouse’s postsecondary school and its authorized financial administration agents and auditors; any financial institution in which my spouse and I have a joint account, if my spouse identified it to the ministry or NSLSC for the purposes of direct deposit and repayment of financial assistance; bodies identified on this application form by name or bodies that administer programs identified on this application; persons or bodies, including government bodies within and outside of Canada, that administer any form of financial assistance and that may have information about my sources of income, assets or residency; other parties used by the ministry to administer and finance OSAP; HRSDC’s contractors and auditors; and collection agencies operated or retained by the federal or provincial governments.

• I understand that the personal information I provide in connection with this application can be accessed by my spouse. Other personal information relevant to a reassessment or appeal will be disclosed to my spouse and any person(s) authorized by my spouse to have access to all information in my spouse’s 2012-2013 OSAP and OTG file.

• I understand that I can withdraw any consent I have given by writing to the Director, Student Financial Assistance Branch, Ministry of Training, Colleges and Universities, PO BOX 4500, 189 Red River Road, 4th Floor, Thunder Bay, ON P7B 6G9, at any time before my spouse accepts financial assistance. I understand that if I withdraw any consent it will affect my spouse’s eligibility for and the type and amount of OSAP assistance.

I have read and understood all parts of this section, including the notice of collection, use and disclosure of my personal information, and my

signature attests to my consent to the indirect collection, use and disclosure of my personal information and that my declaration is complete and

true.

960 Signature of Spouse Date

Day Month Year

Spouse’s Consent to the Indirect Collection and Disclosure of Information from Income Tax Returns (REQUIRED) • I authorize the Canada Revenue Agency (CRA) to release to the ministry, or an authorized third party administrator as identified by the ministry,

information from my income tax returns and, if applicable, other required taxpayer information about me (“the information”), whether supplied by me or by a third party. The information will be relevant to, and used solely for the purpose of the administration and enforcement of OSAP. The ministry will not disclose the information to any person or organization except to my spouse or where authorized by or where required by law. The ministry administers OSAP under the authority of the Ministry of Training, Colleges and Universities Act, and R.R.O. 1990, Reg. 773, Reg. 774, and Reg. 775, O. Reg. 268/01 and O. Reg. 118/07; s. 10.1 of the Financial Administration Act, R.S.O. 1990, c. F. 12, as amended; the Canada Student Financial Assistance Act, S.C. 1994, c. 28, as amended; and the Canada Student Financial Assistance Regulations, SOR 95-329, as amended and s. 266.3(4) of the Education Act. This consent applies to the 2011 and 2012 taxation years.

961 Signature of Spouse Date

Day Month Year


Page 22

Section N: Consents, Instruction, Declarations and Signature of Applicant Collection and Use of Personal Information Your personal information, including your Social Insurance Number (SIN), provided in connection with this and any previous applications and awards of financial assistance will be used by the Ministry of Training, Colleges and Universities (ministry) to administer and finance the Ontario Student Assistance Program (OSAP) and the Ontario Tuition Grant (OTG) and by Human Resources and Skills Development Canada (HRSDC) to administer and finance the Canada Student Loans Program (CSLP). Your SIN will be used as a general identifier in administering OSAP. The ministry and HRSDC may use other parties for any of these activities. Under agreement with HRSDC, the National Student Loans Service Centre (NSLSC) uses your personal information to administer OSAP and CSLP. Under agreement with the ministry, your postsecondary school and, where authorized by the ministry, its agents who administer OSAP and its auditors use your personal information to administer OSAP and CSLP. Administration includes: determining your eligibility for financial assistance; verifying your application, including verifying financial assistance provided under any other ministry program; paying your financial assistance; verifying your financial assistance and any relief granted from any payment you are required to make; considering any applications for review or appeals of determinations relating to your financial assistance or eligibility for relief from any payment; auditing your file; assessing and collecting loans, overpayments and repayments; enforcing the legislation set out below and your agreements with the ministry, the Ontario Student Loan Trust and HRSDC; and monitoring and auditing the NSLSC and your postsecondary school or its authorized agents to ensure that they are administering the programs appropriately. In addition, administration by the ministry and HRSDC includes public reporting on the administration and financing of student assistance programs and accessibility to postsecondary education; planning, delivering, evaluating and monitoring student assistance programs for quality and improvements in both content and delivery; conducting risk management, error management, audit and quality assessment activities; conducting inspections or investigations; and conducting policy analysis, evaluation, and research related to all aspects of student financial assistance and accessibility to postsecondary education, including developing key performance indicators about your postsecondary school such as the aggregated Ontario Student Loan default rates of its students and establishing and monitoring the minimum amount of student aid your postsecondary school is required to provide under the Student Access Guarantee, if applicable. You may be contacted to participate in surveys related to student assistance programs and accessibility to postsecondary education. Financing includes: planning, arranging or providing funding of the programs. The ministry collects your personal information under the authority of the Ministry of Training, Colleges and Universities Act, R.R.O. 1990, Reg. 773, Reg. 774, and Reg. 775, O. Reg. 268/01 and O. Reg. 118/07; s. 10.1 of the Financial Administration Act; the Canada Student Financial Assistance Act, S.C. 1994, c. 28, as amended; and the Canada Student Financial Assistance Regulations, SOR 95-329, as amended and s. 266.3(4) of the Education Act. If you have any questions about the collection or use of this information, contact the Director, Student Financial Assistance Branch, Ministry of Training, Colleges and Universities, PO Box 4500, 189 Red River Road, 4th Floor, Thunder Bay, ON P7B 6G9; (807) 343-7260.

Your Consent to the Indirect Collection and Disclosure of Personal Information (REQUIRED) • I agree that until my loans, overpayments, and repayments are assessed and repaid, the ministry can, without limitation, collect and exchange

personal information about me that is relevant to the administration and financing of OSAP, OTG and CSLP with: HRSDC; Canada Revenue Agency (CRA); NSLSC; my postsecondary school and its authorized financial administration agents and auditors; any financial institution I have identified to the ministry or NSLSC for the purposes of direct deposit and repayment of my financial assistance; bodies identified on this application by name or bodies that administer programs identified on this application; persons or bodies, including government bodies within and outside Canada, that administer any form of financial assistance and that may have information about any of my sources of income, assets or residency or any defaults in repayment of a loan, grant or award made by a government body; other parties used by the ministry to administer and finance OSAP and OTG; HRSDC’s contractors and auditors; collection agencies operated or retained by the federal or provincial governments; and consumer reporting agencies.

• I agree that the ministry may use my personal information for the administration and enforcement of other applications I make to the ministry for financial assistance and of any OSAP or OTG application made by my spouse, any dependent children and/or my parent(s).

• If I received a Queen Elizabeth II Aiming for the Top Scholarship last year, I agree that my postsecondary school may inform the ministry if I have met the academic standard for its renewal.

Your Instruction to Obtain a Consumer Report (REQUIRED) • This is my instruction authorizing the ministry to obtain information about my credit history from a consumer reporting agency for the purpose

of determining whether I am eligible for financial assistance.

Your Declaration (REQUIRED) • 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 my application or as directed by my

financial aid office or the ministry. • I have advised my dependants who are 16 years of age or older that I have provided limited personal information about them on this

application. I have shown them this section and I have obtained their consent to the disclosure and use of their limited personal information for the administration and financing of OSAP.

• I understand that I am responsible for promptly notifying my financial aid office or the ministry in writing of changes to any information I have provided, including the income or assets reported by me (or my spouse or parent(s), if applicable) and my financial institution, or of changes to my address and/or financial, academic, family, and/or period of study status.

• I understand that information I provide will be verified and the ministry may also conduct audits and investigations. • I understand that any change to the information I provide and any change resulting from verification and audit will result in a reassessment. • I understand that if my application is reassessed, it may affect my eligibility and the type and amount of financial assistance. If I received

financial assistance in excess of my entitlement, I will promptly repay all or part of my grants, loans, bursaries, and/or scholarships, or my future loans may be reduced by the amount I owe.

• I understand that if I am not eligible for a particular student financial assistance program, this may affect my eligibility for other loans, grants, awards, scholarships, or benefits.

• I will not receive student financial assistance from any other province, territory, state, or country while receiving OSAP assistance and I have not defaulted in repayment of a loan, grant or award made by any other province or territory.

• I must have financial assistance to continue my postsecondary studies, and I will use this financial assistance to pay my academic fees first and then to cover educational and living costs related to my studies.

• I acknowledge and agree that the postsecondary school must forward the full amount of any refund of academic fees to the lending institution that holds my student loan for credit against such loan.


Page 23

• I understand that I can withdraw any required consent I have given by writing to the Director, Student Financial Assistance Branch, Ministry of Training, Colleges and Universities, PO Box 4500, 189 Red River Road, 4th Floor, Thunder Bay, ON P7B 6G9, at any time before I accept financial assistance. I understand that if I withdraw any of my required consents it will affect my eligibility for and the type and amount of financial assistance.

• I understand that if I fail to provide complete and true information; fail to promptly notify my financial aid office or the ministry in writing of changes to the income or assets reported by me (and my spouse or parent(s), if applicable) and my financial institution or any changes to my address and/or financial, academic, family, and/or period of study status; or fail to fulfil any obligations respecting the repayment of any loan or overpayment, the ministry may restrict me from receiving financial assistance in the future, including the Ontario Student Opportunity Grant, and may take legal action and may require me to repay any financial assistance that I received. I further understand that it is an offence to knowingly provide false information for the purpose of obtaining or receiving OSAP assistance. If convicted, I may be liable for a fine of up to $25,000 and one year in prison.

725 Signature of Applicant Date

Day Month Year

Your Consent to the Indirect Collection and Disclosure of Information from Income Tax Returns (REQUIRED) • I authorize the Canada Revenue Agency (CRA) to release to the ministry, or an authorized third party administrator as identified by the ministry, information from my income tax returns and, if applicable, other required taxpayer information about me (“the information”), whether supplied by me or by a third party. The information will be relevant to, and used solely for the purpose of, the administration and enforcement of OSAP. The ministry will not disclose the information to any person or organization except where authorized by or where required by law. The ministry administers OSAP under the authority of the Ministry of Training, Colleges and Universities Act, and R.R.O. 1990, Reg. 773, Reg. 774, and Reg. 775, O. Reg. 268/01 and O. Reg. 118/07; s.10.1 of the Financial Administration Act; the Canada Student Financial Assistance Act, S.C. 1994, c. 28, as amended and the Canada Student Financial Assistance Regulations, SOR 95-329, as amended and s. 266.3(4) of the Education Act. This consent applies to the 2011, 2012 and 2013 taxation years.


Day Month Year

Your Consent to the Indirect Collection and Disclosure of Information from the Social Insurance Register (REQUIRED) • I consent to the verification of my Social Insurance Number, name, date of birth, and gender with information contained in the Social Insurance Register. This verification is solely for the purpose of confirming the accuracy of my identification in the context of my application for CSLP.


Day Month Year

Your Consent to the Release of Personal Information (OPTIONAL)

(Sign here only if you indicated that you wish to have information about your application and financial assistance released to anyone other than yourself)

• I authorize the ministry and the financial aid office at the postsecondary school I plan to attend to release to the person(s) named on this application any information contained in my OSAP and OTG file for the 2012-2013 academic year and all prior academic years. This consent is valid from the date I submit this application, during my 2012-2013 academic year, and for an additional 180 days after my period of study end date. I may withdraw this consent by writing to the Director, Student Financial Assistance Branch, Ministry of Training, Colleges and Universities, PO Box 4500, Thunder Bay, ON P7B 6G9.


Day Month Year


Page 24

Office Use Only Office Use only for Private Postsecondary Schools in Ontario

001 Cost code

002 Year entering

003 Study period start date

Day Month Year

004 Weeks

005 Percentage of a course load

I confirm the student’s study period information as provided above is correct.

006 Signature of financial aid office staff Staff name Date

Office Use only for Ontario Public Colleges and Universities

001 Cost code

002 Year entering

I confirm the student’s study period information as provided above is correct.

003 Signature of financial aid office staff Staff name Date

PLEASE PRINT

PLEASE PRINT

007 Study period ending date

Day Month Year

Documents

Ontario Student Opportunity Grant Canada Student Grant for ... · Check the FIRST statement that describes your current situation. Check only one box. Read and follow carefully the