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nReasons beyond their Control - Service Canada

SC ISP-3040 (2017-01-05) E 1 / 2 Disponible en fran aisService CanadaPROTECTED B (when completed)Statement - Spouses or Common-law Partners Living Apart for Reasons beyond their ControlWhen a married or common-law couple is living apart for reasons beyond their Control , the Guaranteed Income Supplement (GIS) and Allowance (ALW) payments may be calculated based on individual income rather than combined income if it is to the advantage of the couple. If you are living apart from your spouse or common-law partner for reasons beyond your Control , please complete the following sections in order for us to assess your IN CAPITAL LETTERS using black or dark blue inkSection A: Personal informationInformation about youGiven nameMiddle name or initialFamily nameSocial Insurance NumberTelephone numberCurrent address (No.)

- federal institutions, provincial authorities and public bodies created under provincial law that the Minister of Employment and Social Development Canada may have entered into an agreement with; - non-governmental third parties for the purpose of administering the OAS program, other acts of Parliament and federal or provincial law; and

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