If you have worked for the employer, complete this section.
If you have no work history with the employer, please leave this section blank. You may have no work history with the employer in cases where you were charged a prohibited fee by a temporary help agency, but you never actually worked for the temporary help agency.
Write your job title and describe in a few words, the kind of work you did for this employer.
A record of your hours of work can include anything that is in writing that shows the hours you worked. For example, you may have noted the hours you worked in a diary or calendar, or you may have kept printouts of your work schedule from your employer.
You may be asked to send in photocopies of your record of hours during an investigation of your claim.
If your hours of work changed from day to day or from week to week, please put a check mark (✓) in the "No" box, and explain why your hours were not regular.
How many hours did you work each day?
Tell us how many hours you worked each day. For example, “8 hours.”
How many days did you work each week?
Tell us how many days you worked in each week. For example, “5 days.”
Total number of hours worked each week
Tell us the total number of hours you worked in each week. To figure out this number, multiply the number of hours you worked in each day by the number of days you worked each week. For example, “40 hours” (8 hours x 5 days).
Did the employer pay you every week, every two weeks, twice every month, once every month, or some other period?
Please tell us how you were paid.
What was your regular pay before taxes? Were Canada Pension Plan (CPP), Employment Insurance, etc. taken out of your pay? Do not include in this amount any overtime pay that you may also have earned.
Enter the date when you started employment with the employer. If you cannot remember the exact day, enter the month and year that you started working for the employer. Note: Even if you began a period of training on the first day of employment, you should count that day as your first day of employment.
Enter the date when you last worked for the employer. If you cannot remember the exact day, enter the month and year that you last worked for the employer.
Were you told before your last day on the job that you were going to be fired or let go? If “yes,” put a check mark (✓) in the “Yes” box. If “no,” put a check mark (✓) in the “No” box.
If you are still working for the employer, please put a check mark (✓) in the “Not Applicable” box.
If you were told that your employment was going to be terminated or you were going to be laid-off before your last day on the job, please state the date when you were told. If you are still working for the employer, please write “not applicable” or “n/a”.
How was the notice of termination given to you?
This information is provided as a public service. Although we endeavour to ensure that the information is as current and accurate as possible, errors do occasionally occur. Therefore, we cannot guarantee the accuracy of the information. Readers should, where possible, verify the information before acting on it.
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