Declarations · Common-law
Common-Law Statutory Declaration for Benefits and Insurance
People who fill out this document also need
Also known as: Declaration of Common-Law Relationship · Common-Law Affidavit for Benefits · Spousal Declaration for a Benefits Plan · Proof of Common-Law Status · Declaration of Cohabitation
Contents
CONTENTS
For a plan, not for immigration
When you add a common-law partner to a health and dental plan, name them on a pension, or ask an insurer to treat you as spouses, the plan usually wants a written declaration that you live together in a conjugal relationship and since when. This template is written for exactly that.
It is not the IRCC form. Immigration applications use IMM 5409, which has its own boxes and questions; you can fill in IMM 5409 here. If your benefits administrator sent you its own form, use theirs and upload it when you book.
What the declaration states
Both partners are named with their dates of birth and the address you share. The declaration then states that you have lived together continuously in a conjugal relationship since a given date, that you are not married to each other, and whether either of you is still legally married to someone else. That last point matters to some plans, so the template asks it directly instead of leaving it out.
You can add your children together and any other facts you want on record, such as a joint account or both names on the lease. The last line names what the declaration is for.
Choosing the start date
Plans often require a minimum period of living together, commonly one year, before a partner qualifies. The start date you give is the day you began living together at the same address, not the day you met. Our form shows how many full years that is today, so you can see before you book whether you meet the plan's period.
If you moved together between several homes, the date is still the first day you lived together. Only the current shared address goes on the declaration.
Details plans tend to question
- Different addresses on your IDs. Not a problem in itself, but be ready to explain. The declaration states the address you live at now.
- A start date that does not match the enrolment form. Use the same date everywhere you report it.
- Leaving out a legal marriage to someone else. If one of you is separated but not divorced, say so in the box the form gives you. A plan finding it later is worse.
- One partner signing alone. Both partners declare it. Each of you joins the video signing from your own device.
Declaring it together by video
Press Book and Sign, add your partner's email and both photo IDs, and pay. On the call the commissioner checks both IDs, each of you confirms the declaration, and you both sign on screen. The commissioned PDF is emailed to you both, ready to send to the plan.
Already have it filled in?
Upload your own copy when you book and sign it with us by video.
FAQ
Can I use this for my spousal sponsorship or PR application?
No. IRCC uses IMM 5409, which you can fill in on our IMM 5409 page.
Do we both need to be on the call?
Yes. You both sign, each from your own phone or computer, even from different cities.
One of us is still married to someone else. Can we still sign?
Yes. Untick "Neither of us is legally married to anyone else" and explain it in a sentence or two.
How long do we need to have lived together?
That depends on the plan. Many ask for one year. Check the plan's rules; we do not decide eligibility.
Can I download the declaration?
No. It is attached to your booking and signed on the video signing; the commissioned PDF is emailed to you afterwards.
Do you check whether we qualify as common-law?
No. We verify your identities and commission the declaration you wrote.
We don't provide legal advice.
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