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Hepatitis C - Class Actions Settlement
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Claimants:
Essential Information
Claimants:
Additional Information
Claimants:
Loss of Income / Loss of Support / Loss of Services
Periodic Re-Assessment by the Courts
Appeals
Documents
Forms
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Administrator


 

Loss of Income

Download the Forms

You may wish to download PDF versions of the forms relevant to your Loss of Income claim. Use them to practice before filling out the actual forms.

Please note that you need to fill out the official printed forms which the Administrator will mail to you.

NOTE: You will need Acrobat Reader to view these PDF documents.

  • Form GEN 10: Loss of Income/Support - Master Form (Assistance in filling out this form)
  • Form GEN 10A: Supplemental Income/Information Form - Federal
  • Form GEN 10B: Supplemental Income/Information Form - Provincial
  • Form GEN 10C: Self-Employment Information Form
  • Form GEN 11: Activities of Employment (Complete this Form for some claims for Loss of Income)
  • Form GEN 19: Authorization to Release Employee's Information Form (Complete this Form if making a claim for Loss of Income/Loss of Support)
  • TRAN 2 / HEMO 2 Treating Physician Form
  • Indexation Chart