Service Canada Separation of Legal Spouses or Common-Law Partners | Free Template

You may need to complete this form if the following applies to you:

• You’re married and have separated from your spouse
• You were in a Common-Law relationship that has ended
• Service Canada has requested confirmation of your separation
• Your separation impacts your income, benefit eligibility, or payment amounts

You should complete this form as soon as possible to avoid overpayment, reassessment, and delays.

You may need this form to update your marital status with Service Canada to receive federal program benefits such as:

• Canada Pension Plan (CPP)
• Guaranteed Income Supplement (GIS)
• Old Age Security (OAS)
• Employment Insurance (EI)

This form must be completed correctly to be accepted by Service Canada. Missing or incorrect details can delay processing or lead to follow-up requests from Service Canada.

You should include the following information, including:

• Your full name
• Your Social Insurance Number (SIN)
• Your current address and contact information
• Your spouse or common-law partner’s full name
• The date of separation
• The reason for your separation
• The date you last resided together
• Confirmation that you’re not living together as a couple
• A declaration that the information provided is truthful
• The name and address of the person your ex-partner lived with after you
• • This only applies if your ex lived in a common-law relationship with someone else during your separation.

You must have your Separation of Legal Spouses or Common-Law Partners form commissioned for it to be considered valid. Commissioning involves signing your form in the presence of an authorized official, like a notary public.

You can meet with a notary public online to have your form commissioned in under 7 minutes.

By commissioning the form, you formally declare that the information you’ve provided is accurate. Providing false information can result in penalties or the reassessment of benefits. Once commissioned, submit the form to Service Canada per its instructions.