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Ontario Works Online Document Submission Form

The Ontario Works Online Document Submission Form is meant for clients who have been directed to this portal due to the inability to use the province’s MyBenefits online portal, or for third party submissions.

This form is for document submissions for the local office only and is NOT meant to be used to apply for Ontario Works or Income support. For more information about applying for social assistance, please visit the Social Assistance page on the government of Ontario’s website.

First Name

Last Name

Date of Birth mm/dd/yyyy

Phone Number

Member ID

Caseworker's Name

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Personal information, as defined in the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA), is collected and authorized under Section 10(1) of the Municipal Act, 2001. You may be contacted for more information. Questions about this collection can be directed to the Communications and Community Engagement Department 58 Dalhousie St, Brantford, ON N3T 2J2, or communications@brantford.ca or 519-759-4150.