Schedule B - Address Authorization Form printable pdf download

Schedule B - Address Authorization Form

SCHEDULE B

ADDRESS AUTHORIZATION FORM

To be completed by a Certified Agency for applicants who are 18 years of age or older who are currently homeless.

INSTRUCTIONS



Complete all mandatory fields on the form. Please type or print all information legibly;



Print the form double-sided and on the Certified Agency’s letterhead;



The applicant, the Certifier and Certified Agency’s Chief Executive Officer (CEO) or designate must read and sign the

form;



Check off the applicable Certified Agency on the back of the form;



Retain a copy of the form for the Certified Agency’s records; and



The applicant must bring the completed form and the appropriate fee, along with proof of identity and proof of legal

entitlement to be in Canada, to a Registry Agent when applying for a government-issued Alberta Identification Card.

The completed Address Authorization Form will serve as proof of the applicant’s residence in Alberta.

ELIGIBLE APPLICANTS

Eligibility for the Address Authorization Form is limited to applicants who are: 1) residents of Alberta, 2) 18 years or older,

3) currently homeless, and 4) who have resided in Alberta for at least 90 days.

A resident of Alberta is a person who: is lawfully entitled to be or to remain in Canada; and makes his or her home in,

and is ordinarily present in Alberta.

Form: HUA_001

Schedule B - Address Authorization Form