Claim

What is your first and last name?

First name and family name

What is your email address ?

Email

Confirm Email

Phone

Are you completing this form on your own behalf or on behalf of a third party whom you are authorized to represent (minor, incapacitated adult, or estate)?

On my own behalf
For a third party

If you are filing the claim for a third party, please enter the name of the claimant for whom the claim is being submitted.

What is the first and last name of the claimant .

If you are filing the claim for a third party, what is your relationship to this person?

Other than for your children, do you have a document authorizing you to file the claim for a third party? (Mandate, will, etc.)

Yes
No

If yes, please upload the document.

Drag & Drop Files, Choose Files to Upload You can upload up to 4 files.

On what basis is the claim being made?

A) The claimant was both the owner or co-owner and occupant of a unit in a building covered by the class action
B) The claimant was a tenant or co-tenant occupying a unit in a building covered by the class action
C) The claimant occupied a unit in a building covered by the class action without being the owner or tenant (child, spouse, other)
D) The claimant was the owner of a unit in a building covered by the class action, but the unit was rented to a third party

documents filing or

If you selected C in the previous question, enter the first and last name of the owner or tenant of the unit with whom the claimant resided.

Enter the first and last name of the owner or tenant.

If you selected B or D, please provide a copy of the lease or any other document proving the rental. A sworn statement may be accepted as proof.

Drag & Drop Files, Choose Files to Upload You can upload up to 4 files.

A défaut de produire votre bail , une déclaration sous serment à cet effet serait acceptable.

Which building is the claim for?

Which unit?

2 Identity documents for adult claimants are required

Drag & Drop Files, Choose Files to Upload You can upload up to 4 files.

(If the claimant is a child of the owner or tenant, please go to the next section.) Please upload two (2) government-issued photo IDs, such as: • Québec Health Insurance Card • Passport • Driver’s licence

2 Identity documents for child claimants (minor or adult) are required

Drag & Drop Files, Choose Files to Upload You can upload up to 4 files.

Please upload the birth certificate. And one of the following: • Québec Health Insurance Card • School report card • Passport • Driver’s licence • Childcare expense statement (R24)

Did the claimant occupy the unit in the building for the entire period from May 1, 2016, to March 30, 2019

Yes
No

If you answered No, please indicate the claimant’s move in date

JJ-MM-AAAA ( numbers only)

If you answered No, please indicate the claimant’s move out date

JJ-MM-AAAA ( numbers only)

Current address of the claimant

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Payment method

Interac payment (faster)
Cheque sent by regular mail

Interac payment password to be used when accepting the deposit into your account.

Password

Confirm Password

A password all in one word ( no space ) length between 8 and 25 characters, with complexity requirements (uppercase letters, lowercase letters, numbers, special character). (Example: Ilovedmy2026vacation$)

Signature .I declare that the information provided is accurate

First name and family name