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Section 6 – Amounts Owing in default to the province
If you owe any amounts that are in default to the Province, please list them below.
Nature of the amount in
default (Penalties,
overpayments, etc)
Source of amount in default
(Employment Program, Income
Support, etc.)
Declaration/Attestation:
I certify that the information that the information provided is true, accurate, and complete in every respect. If the
information described above is false or misleading I understand I may be required to repay some, or all, financial
assistance that may be approved by the Province.
I recognize that any amounts owing in default to the Province may be deducted from, set-off against, or recovered
by other means from amounts payable to me under any contribution agreement.
I give permission to the Department of Immigration, Population Growth and Skills to exchange and release
my personal information, or the information of my dependent(s) to any person, agency, or government
department, for the purpose of: assessing my eligibility for services and benefits; administering benefits;
coordinating and providing follow-up services; and improving the quality of services and benefits offered. The
personal information collected will be used for the administration of the program for which I have applied.
Applicant Signature
Date
For EI Eligible applicant’s funding may be provided by Newfoundland and Labrador under an agreement with
Canada made pursuant to section 63 of the Employment Insurance Act. The personal information collected will
also be shared with Canada or the Canada Employment Insurance Commission to administer the Employment
Insurance Act and could impact your receipt of benefits under Part I of the Act. The Canada Employment Insurance
Commission may also use any personal information it receives for policy analysis, research, and evaluation
purposes.
The personal information collected may also be shared with the provincial Department of Justice and Public Safety
for the purposes of administering the Support Enforcement Act. The processing of an application for assistance will
include independent verification of an applicant’s status with respect to Support Orders. This may result in
garnishment of a portion of any approved funding under section 15 (2) (a) and section 19 of the Support Orders
Enforcement Act, 2006 SNL 2006, c.5-31.1, for payment of any arrears owing.
Information on this form is collected for the purposes of assessing eligibility for and administering the NL Skills
Development program under Section 32(c) of the Access to Information and Protection of Privacy Act, 2015 and is
subject to all the provisions of the Act. If you have any specific questions concerning the collection, use, or
disclosure of personal information please contact the Department of Immigration, Population Growth and Skills
at ipgs@gov.nl.ca.
