Language selection

Search

Financial Claim – Youth Employment and Skills Program

Instructions for completing this form

You can use either the PDF (63 KB) version of the form or the Web version below.

Please complete, print and send the form by email to aafc.yesp-pecj.aac@canada.ca or mail to your regional office or closest region.

Personal information will be protected under the provisions of the Privacy Act and will be stored in Personal Information Bank AAFC/PPU130.

Type of claim:
Claim period:

Salary and benefits by pay period
Pay Period Gross Salary Employee Benefits paid by Employer (not on pay slips)
From To Canada Pension Plan Employment
Insurance [1]
Workers' Compensation Other
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
Totals
[1] The employer's contribution is typically 1.4 times the amount deducted from the employee's pay slips
Totals
Total Gross Salary
50% of the Total Gross Salary
Total of Employer Paid Benefits
50% of Employer Paid Benefits
Total Claim [1][2]
[1] For mid-point claims the limit is 50% of the agreement amount
[2] Final claims are limited to the total amount in your agreement
Proof of payment of salary included with this claim

I agree that these expenditures are an accurate and true reflection of expenditures incurred on this project.

Signature

I agree that I have received that above stated wages and benefits in accordance with the terms of this project.

Signature

Report a problem on this page
Please select all that apply:

Date modified: