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6.9 Signing the Application
6.9.1 PRINTING THE EIA APPLICATION AND ACTION PLAN IN WINNIPEG
When the intake worker has completed
- the on-line application; and
- an action plan for each adult who is required to perform one
or more action steps
the application and action plan are printed for the applicant's review.
Both EIA and the applicant have legal rights and obligations that
flow from the EIA application and the action plan. Accordingly, the
intake worker takes the time to carefully review a printed copy of
these two documents with all applicants to be certain of their accuracy
before signing. If there is any doubt whether the applicant understands
the contents and significance of the two documents, it is the intake
worker's duty to read the recorded information back to the applicant
for confirmation and to explain its importance in the process of assessing
EIA eligibility and service needs.
Where there are two adults in an applicant's household, assistance
can only be provided after both the applicant and the second adult
sign the completed application. If applicable, both the applicant
and the second adult also sign their respective action plans. (For
more on the action plan, see section 6.5.2).
The intake worker witnesses the signature of the applicant (and
the second adult, if applicable). The applicant and second adult
legibly print their names beside their signature, as indicated on
the application form. The applicant, the second adult, and the intake
worker also sign and date each action plan.
Because the action plan documents any steps to be undertaken,
a copy of each action plan is always provided to applicants (and
the second adult, if applicable). On request, applicants will also
be provided with a photocopy of their signed application form.
The EIA application is a legal document, under which both the applicant
and EIA have rights and obligations.
Protection of applicants' privacy rights
Under The Freedom of Information and Protection of Privacy Act
and The Personal Health Information Act, EIA can only collect
personal information and personal health information that is necessary
for a legitimate program activity, such as:
- determining the applicant's eligibility for assistance and the
amount of assistance;
- meeting the applicant's financial, employment, medical and other
service needs; and
- preventing and detecting fraud.
The EIA application form has been carefully reviewed to ensure that
only necessary personal information or personal health information
is collected. Applicants who have questions or concerns regarding
the collection of personal information or personal health information
should be encouraged to contact the Family Services and Housing Access
and Privacy Coordinator at 945-2013.
Applicants' consent to disclosure of personal information and
personal health information
When they sign the EIA application form, applicants also consent to
the disclosure of any personal information and personal health information
necessary to verify the household's eligibility for assistance and/or
the amount of assistance. This consent applies to the disclosure of
personal information and personal health information by EIA, as well
as by any person, agency or organization, including federal, provincial
and municipal governments and Indian bands.
Any personal information or personal health information disclosed
to EIA staff is strictly confidential and is to be used solely for
the purpose of determining or verifying applicants' eligibility
for assistance and/or the amount of assistance to be provided. Further
disclosure of applicants' personal information or personal health
information without their consent is a violation of The Freedom
of Information and Protection of Privacy Act and The Personal
Health Information Act.
Declaration
Applicants (and the second adult, if applicable) declare that the
information they provide in their EIA application is true and complete
to the best of their knowledge, and that they have not misrepresented,
concealed or omitted any relevant information.
Applicants (and the second adult, if applicable) also acknowledge
their ongoing responsibility to immediately report the details of
any future change in circumstances that may affect eligibility for
assistance and/or the amount of assistance. Examples of such changes
include receiving previously unreported earned or unearned income,
or changes of marital or family status.
Declaration of the applicant's legal representative
This declaration is only signed when someone other than the applicant
has assumed legal responsibility for the applicant's financial affairs.
Most applications of this nature are received from the Public Trustee
on behalf of applicants subject to a supervision order or for whom
a substitute decision maker has been appointed.
Revenue Canada authorization
The purpose of this authorization is to give EIA access to the income
tax returns and other taxpayer information of the applicant (and the
second adult, if applicable), to verify the household's eligibility
for assistance and/or the amount of assistance.
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