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FRO-005E (11/2003) © Queen’s Printer for Ontario, 2008 Page 1 of 10

Family Responsibility Office

Instructions for Recipients of Family Support

This filing package includes forms to be completed and returned to the Family Responsibility Office as soon as possible.

The Family Responsibility Office requires this information to begin the enforcement process to collect support payments

on your behalf.

1. Support Filing Form

It is important that you provide the requested information about your support provisions and where we can

contact you by mail and telephone.

If you are not already filed with the Family Responsibility Office or if your order or agreement was previously

withdrawn from the Family Responsibility Office, you must complete this form and attach a copy of your Order or

Agreement.

NOTE: if you are filing a Marriage Contract, Separation Agreement, Cohabitation Agreement or Paternity

Agreement, please provide a stamped copy showing that it has been filed with the Ontario Court Court of Justice or

the Supreme Court of Justice Family Court. A sworn “Affidavit for Filing of Domestic Contract or Paternity

Agreement” must also be attached.

YOU MUST SIGN THE SUPPORT FILING FORM AT THE BOTTOM WHERE SHOWN.

2. Registration for Direct Deposit Form

Completion of this form authorizes the Family Responsibility Office to deposit payments collected directly to the

bank of your choice. Funds are received faster when payments are directly deposited.

3. Payor Information Form

Please answer all the questions as completely as possible and return it to our office. If you cannot answer a question,

write “DO NOT KNOW” so that we know you saw the question but did not have the information at the time. If

there is not enough space provided, please attach a separate sheet of paper.

4. Statement of Arrears Form

This form must be completed in order for the Family Responsibility Office to begin collecting the arrears you are

owed. Please note Cost of Living Adjustment (COLA) changes. A copy of this form will be provided to the support

payor and this form becomes a court document if we take action to enforce support payments. It must therefore be

signed in the presence of a Commissioner of Oaths, Justice of the Peace or Notary Public.

Check List

Support Filing Form (Form must be signed)

Registration for Direct Deposit (Section “B” must be completed OR void cheque attached)

Payor Information Form (Provide as much information as possible)

Statement of Arrears (Form must be signed and your signature witnessed)

Clear Form

FRO-005E (11/2003) Page 2 of 10

Ministry of Community

and Social Services

Family Responsibility Office

P.O. Box 220

Downsview ON M3M 3A3

Support Filing Form

Language Preferred: English French

Case Number

Last Name First Name Middle Initial

Address: Street Number and Name / Apartment Number Lot, Concession or Township

City / Town Province Postal Code

Home Telephone Number

Area code ( ) _________________

Date of Birth:

Day / Month / Year ______ / ________ / _______

Social Insurance Number

___________ - ___________ - ___________

Employer:

Work Telephone Number

Area code ( ) _________________

Last Name of Person Owing Support First Name Middle Initial

My Support Provisions are contained in a (check one)

Court Order Separation Agreement Marriage Contract

Cohabitation Agreement Paternity Agreement Date ________ / ________ / ________

Day Month Year

(Agreement / Contract must be filed with the Ontario Court of Justice or Superior Court of Justice Family Court)

Are you claiming spousal support for yourself? Yes No

Are you claiming support for the child(ren) named in the order / agreement? Yes No

If yes, list the name(s) of the child(ren) you are claiming support for (use additional sheet if required)

Last Name, First Name, Initial(s)

Date of Birth

Day / Month / Year

Sex

Male Female

Do you currently receive or have you applied for Family Benefits General Welfare No

Do you have another case filed with the Family Responsibility Office? If yes, please provide the name that the case is

filed under and the case number.

Name case is filed under Case Number

You must sign this form in order for the Family Responsibility Office to enforce the support terms of your order/

agreement / contract.

Signature Date

FRO-005E (11/2003) Page 3 of 10

Ministry of Community

and Social Services

Family Responsibility Office

P.O. Box 220

Downsview ON M3M 3A3

Registration for

Direct Deposit

Case Number

When the Family Responsibility Office receives a support payment that is owed to you, these funds will be sent by

DIRECT DEPOSIT to the bank of your choice. To ensure that you receive your money quickly, the following information

must be provided. Incorrect information could result in your payment being sent to the wrong account.

Instructions

If you wish to have your support payments deposited into your CHEQUING ACCOUNT, COMPLETE SECTION

‘A’ and ATTACH A BLANK PERSONAL CHEQUE with ‘VOID’ written on it.

If, however, you wish to designate your SAVINGS ACCOUNT, complete SECTION “A”, take this form to your

bank and ask them to complete SECTION “B” – Banking Data.

DO NOT FORGET TO SIGN THE BOTTOM OF THE FORM AUTHORIZING THE DIRECT DEPOSIT SERVICE

Important notes about changing bank accounts

If your account number changed, or if you wish to have your support payments deposited to a different account,

you must complete a new DIRECT DEPOSIT FORM and return it to the Family Responsibility Office. After the

changes have been processed, your support payments will be sent to your new account. DO NOT CLOSE YOUR

OLD ACCOUNT UNTIL YOU RECEIVE YOUR FIRST PAYMENT TO THE NEW ACCOUNT.

SECTION “A” – Support Recipient Information PLEASE PRINT CLEARLY

Last Name First Name Middle Initial

Address: Street Number and Name / Apartment Number Lot, Concession or Township

City / Town Province Postal Code

Telephone number where you can be reached during the day

Area Code ( )

NOTE: If attaching a VOID cheque, please tape the cheque over the Banking Information in Section “B”

SECTION “B” – Banking Information To be completed by your bank if you are not attaching a VOID Cheque

Branch Number Institution Number Account number

Name of Financial Institution

Branch

Place Bank Stamp

Branch Address

Bank Official’s Signature and Position Date

Until further notice, I authorize the direct deposit of my support payments to the account and financial institution

designated in this form.

Signature of Recipient Date

FRO-005E (11/2003) Page 4 of 10

Ministry of Community

and Social Services

Family Responsibility Office

P.O. Box 220

Downsview ON M3M 3A3

Payor Information Form

Information for Recipient to Complete

Page 1 of 3

Case Number

Payor’s Last Name Payor’s First Name Initial

Male Female

Payor’s Address: Street Number and Name / Apartment Number Lot, Concession or Township

City / Town Province Postal Code

Home Telephone Number

Area code ( ) _________________

Payor’s Previous Address: Street Number and Name / Apartment Number Lot, Concession or Township

City / Town Province Postal Code

Payor lived at this address

from________ / ________ / ________ to ________ / ________ / ________

Month Yea

Does Payor use any other name(s)? If so, what name(s)?

Does the Payor have a Driver’s Licence?

Yes No Unknown

If Payor has Driver’s Licence,

Licence Number__________________ Prov. ____________

Social Insurance Number (This may be found on payor’s tax return or your tax return

___________ - ___________ - ___________

Payor’s Date of Birth:

Day / Month / Year ______ / ________ / _______

Payor’s mother’s name before marriage Payor’s Health Insurance Number

Payor’s Marital Status:

Single Married Divorced Separated Cohabiting

Income Information

Indicate if Payor self-employed:

Yes No If yes, give details of employment________________________________________________

(e.g. Sole Owner, Partner, Family Business)

Payor’s Current Employer / Income Source

Payor’s Position Date Started:

Day / Month / Year ______ / ________ / _______

Employer’s Address: Street Number and Name Unit/Suite Number

City / Town Province Postal Code

Employer’s Telephone Number

Area code ( )

Payor’s Previous Employer / Income Source

Payor’s Position Date Started:

Day / Month / Year ______ / ________ / _______

Employer’s Address: Street Number and Name Unit/Suite Number

City / Town Province Postal Code

Employer’s Telephone Number

Area code ( )

FRO-005E (11/2003) Page 5 of 10

Payor Information Form

Information for Recipient to Complete

Page 2 of 3

Property Information

Case Number

Does the payor own / lease / rent a car, truck, boat, snowmobile, farm equipment or recreational vehicle?

Vehicle Type Model Year Colour

Licence Plate number Serial number

Rent Own Lease

Vehicle Type Model Year Colour

Licence Plate number Serial number

Rent Own Lease

Does the Payor own (alone or jointly with another person / company) a house, cottage, farm, land, apartment building, office or

investment property either in or outside of Canada?

Type of Property

Address: Street Number and Name / Apartment Number Lot, Concession or Township

City / Town Province Postal Code

What is / are the name(s) of the person(s) / company who also own this property?

Type of Property

Address: Street Number and Name / Apartment Number Lot, Concession or Township

City / Town Province Postal Code

What is / are the name(s) of the person(s) / company who also own this property?

Please attach additional information on a separate sheet of paper.

Other Information

Do you have the name and addresses of any of the payor’s relatives or friends who may help us locate the payor if required?

Name Relationship to Payor

Address: Street Number & Name / Apartment Number / City / Province / Postal Code Telephone Number

Area code ( )

Name Relationship to Payor

Address: Street Number & Name / Apartment Number / City / Province / Postal Code Telephone Number

Area code ( )

Does the Payor belong to any professional or community groups, associations, clubs, unions that may help us to locate the payor, if

required? (Provide name of organization, address and telephone number if possible.)

FRO-005E (11/2003) Page 6 of 10

Payor Information Form

Information for Recipient to Complete

Page 3 of 3

Case Number

Does the Payor have other sources of income? (e.g. Workers’ Compensation, Employment Insurance Benefit, Disability Insurance,

Pension Income). If YES, provide as much detail as possible, including claim numbers if known.

Please attach additional information (e.g. Business cards, business contacts), on separate sheet of paper.

Does Payor frequently travel outside of Canada?

If yes, for

Business Pleasure Passport Number ______________________________________

Does Payor have any Federal Licences? (e.g. Pilot Licence, Transport Licence)

Type of Licence:_________________________________________ Licence Number ___________________________________

Physical Description of Payor (This information is required if we need to serve the Payor with Court Documents.)

If possible, include a current photograph of the payor. Please attach the photograph to a separate sheet of paper and write the payor’s name, date

the photograph was taken and your case number.

Height Weight Build Eye Colour Eye Glasses

Yes No

Hair Colour Skin Colour Distinguishing Marks or Features (eg. Tattoos)

Financial Information

Does the Payor have any Credit Cards?

Card Type Account Number

Where does the Payor Bank?

Name of Financial Institution Account Number

Address

Name of Financial Institution Account Number

Address

List any other assets you are aware of. (e.g. Stocks, Bonds, Term Deposits, Life Insurance, Investment Certificates, RRSP)

If you require more space, please attach a separate sheet of paper

Type of Asset Location

Account / Policy /

Serial Number

FRO-005E (11/2003) Page 7 of 10

Family Responsibility Office

Statement of Arrears

Instructions

Complete the Statement of Arrears form in pen only, if any support payments are owing to you at this time. The

Family Responsibility Office will begin the process of collecting these missed support payments (called “arrears”) for

you. A copy of this form will be provided to the support payor and this form becomes a court document if we take

action to enforce support payments. It must be signed in front of a Commissioner of Oaths, Justice of the Peace or

Notary Public. A Commissioner is available at all court offices, community legal clinics and municipal or township

offices. A Commissioner is also available at most law offices.

2. To complete the calculations on the Statement of Arrears form write the date on which you were supposed to receive a

support payment, starting with the first payment missed. The due dates for payment are found in your support order /

agreement. If there is no due date, use the date of the order / agreement itself to calculate dates payments are due.

Then indicate if the payment was missed completely or if it was paid in part. List every support payment due after

that, indicating if the payment was missed or paid in part or in full. You must use a separate line for each payment. If

you need more room, fill in “Schedule A” and attach it to the Statement of Arrears. We will try to collect the total

amount of arrears you claim are owing to you on this form.

3. If the arrears you are claiming include interest, please note that the Family Responsibility Office will only take

enforcement action on interest that has accrued as a result of the support payor’s failure to comply with the support

order. Where funds are being remitted to the Family Responsibility Office pursuant to a support deduction order or

garnishment, the support payor has no control over the schedule of payments by the income source or garnishee and,

therefore, the Family Responsibility Office will not enforce any interest owing for delays in the receipt of support

payments. To claim interest, please see Instructions for Completing Interest Calculations.

4. Some support orders and agreements say that support payments must be changed on a regular basis to reflect changes

in the cost of living over the previous year. These provisions are called Cost of Living Adjustment clauses (COLA).

A COLA clause provides for the increase or decrease in the amount of support payments. In order to be enforced by

the Family Responsibility Office, support orders that contain a cost of living adjustment clause must follow either the

standard formula set out in Section 34(5) of the Ontario Family Law Act or Ontario Regulation 176/98.

Under the Family Law Act, the COLA is increased annually on the support order’s anniversary date by the indexing

factor for November of the previous year. The indexing factor for a given month is the percentage change in the

Consumer Price Index for Canada for prices for all items since the same month of the previous year, as published by

Statistics Canada.

Under Regulation 176/98, the following COLA clauses will be enforced by the Family Responsibility Office:

• clauses which apply cost of living adjustments derived from any part of the Consumer Price Index (CPI);

•

clauses which contain a calculation applying a specific rate of increase or decrease in support order or support

deduction order;

•

clauses made in accordance with methods specified in Quebec legislation dealing with cost of living adjustments

in support orders;

•

clauses which contain a calculation by applying the greater or lesser of:

I. percentage change in the payor’s or recipient’s income

AND

II. percentage change in the Consumer Price Index (CPI).

5. If the arrears you are claiming are not for regular on-going support, but are for expenses, please note:

• Depending on the terms of your Order or Agreement, these types of expenses may or may not be enforceable by

the Family Responsibility Office.

• If the Order / Agreement doesn’t include a clear requirement to pay or reimburse these expenses, they are likely

not enforceable. If the expenses are enforceable, the Family Responsibility Office requires a sworn Statement of

Arrears, including the receipts.

FRO-005E (11/2003) Page 8 of 10

Family Responsibility Office

Instructions for Completing Interest Calculations

Please note that the Family Responsibility Office will not take enforcement action on interest that has accrued as a result

of the support payor’s failure to comply with the support order. Where funds are being remitted to the Family

Responsibility Office pursuant to a support deduction order or garnishment, the support payor has no control over the

schedule of payments by the income source or garnishee and, therefore, the Office will not enforce any interest owing for

delays in the receipt of support payments.

When determining the amount of interest owed to you, you should know the following:

i. If your Ontario support order is dated after June 21, 1979, the interest rate must be stated in the order. For

Ontario orders made before June 22, 1979, the rate of interest is five percent (5%) and does not have to be stated

in the order.

ii. Prior to January 1, 1985, the Provincial Court (Family Division) could not award interest.

iii. Under the Courts of Justice Act, interest accruing on a debt is simple interest and not compound interest.

iv. Where the court provides that support be paid on a periodic basis (e.g. $500.00 / month), each payment in default

will bear interest from the date that the payment was due. Therefore, the interest owing for each missed support

payment must be calculated separately.

v. Interest can be calculated by using the following formula:

Principal x Interest Rate x Number of Days the Payment is in Arrears

365 days

Where

The principal is the outstanding individual support payment.

The Interest Rate, established by the Courts of Justice Act or its predecessor, is the rate that was in effect on the

date that the court made the support order.

Example

On January 27, 1992 the court made an order for support in the amount of $500.00 / month. The support payor

has failed to make support payments for the months of July and September, 1992. The prescribed rate of interest

for the first quarter of 1992 is 9%. As of October 1, 1992, the accrued interest is calculated as follows:

Interest on July’s payment is: 500 x 9% x 92

= $11.34

365

Interest on September’s payment is: 500 x 9% x 30

= $3.70

365

Total Interest = $11.34 + $3.70 = $15.04

FRO-005E (11/2003) Page 9 of 10

Ministry of Community

and Social Services

Family Responsibility Office

P.O. Box 220

Downsview ON M3M 3A3

Statement of Arrears

Case Number

Support Recipient’s Name

Payor’s Name

1. I am the support recipient under the following:

Order

Date of Order Court Court File Number

Agreement filed with the Court

Date of Agreement Court Agreement Filed With Court File Number

2. The following amounts due under the order / agreement have not been paid. (If you need more space, complete

“Schedule A”.)

Check if applicable.

See “Schedule A” attached

Date Payment Due

Day/Month/Year

Amount Due

Date Paid

Day/Month/Year

Amount Paid Arrears

If you are entitled to interest on your support, you must calculate the interest amount. Attach a copy of your calculations.

If you are entitled to a COLA adjustment to your support, you must include the adjustment in the amount due. Attach a copy of your

calculations.

Total Arrears

$ (a)

Total Interest to date (if any)

$ (b) Applicable interest rate used _________ %

My arrears as at _______________TOTAL

$ (c)

Date (Add A and B)

You must sign this form in the presence of a lawyer, justice of the peace, notary public or commissioner for taking affidavits

Sworn before me at the of in

the of

this day of , 20

Signature of a commissioner, etc. Signature of Support Recipient

0.00

FRO-005E (11/2003) Page 10 of 10

Ministry of Community

and Social Services

Family Responsibility Office

P.O. Box 220

Downsview ON M3M 3A3

Schedule “A”

To Statement of Arrears Form

Case Number

Date Payment Due

Day/Month/Year

Amount Due

Date Paid

Day/Month/Year

Amount Paid Arrears

Enter amount onto Statement of Arrears Form.

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