Get Ins5140

The Ins5140 is a crucial document that supports your claim for employment insurance sickness benefits. Properly completing this form is essential for ensuring your eligibility for these benefits, and this guide will help you navigate each section with ease.

Follow the steps to successfully fill out the Ins5140 form.

1. Select the ‘Get Form’ button to access the Ins5140 document and open it in your preferred editor.
2. In Section 1, enter your Social Insurance Number and Date of Birth accurately. Provide your last name, first name, and initials as required.
3. Complete your full postal address, including the number and street, apartment number, city or town, postal code, and province or territory. Be sure to double-check these details for accuracy.
4. Input your telephone number and ensure it is valid. This information is needed for communication purposes regarding your claim.
5. Sign the section to authorize the release of your medical information to the insurer and other relevant parties. Make sure your signature matches the name you provided above.
6. If applicable, Section 2 must be filled out by your medical doctor or an authorized health practitioner. They must provide the expected date of confinement and the actual date of confinement, if necessary.
7. Your medical practitioner will also need to indicate the expected recovery date and provide comments regarding your incapacity, if applicable.
8. Ensure your medical doctor's name is printed clearly, along with their specialty, address, area code, and telephone number. Finally, the doctor must sign and date this section.
9. Review the completed form for any errors or missing information before finalizing it.
10. Save any changes made to the form. You can then download, print, or share the Ins5140 form as needed.

Complete your Ins5140 form online today to ensure your eligibility for benefits.