Compassionate Care Benefits - Annex 5 INS5217 2026

1. Click ‘Get Form’ to open the Compassionate Care Benefits - Annex 5 INS5217 in the editor.
2. Begin by filling out your Claimant Information, including your Family Name, Given Name, Initials, and Social Insurance Number.
3. In Section 1, provide details about the ill family member. Include their Family Name, All Given Names (underline the most commonly used), Date of Birth, and Residential Address.
4. Section 2 requires you to specify your relationship to the ill family member. Choose from options such as spouse, child, or sibling.
5. In Section 3, indicate how many weeks of benefits you wish to claim and the start date for these benefits.
6. For Section 4, decide if you want to defer your waiting period if multiple claims are filed for the same family member.
7. Complete Section 5 by confirming whether a medical certificate has been submitted and if you will be submitting one.
8. If applicable, skip Section 6 if you're self-employed and proceed directly to Section 7 where you declare that all information is true before signing and dating the form.

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