Québec Parental Insurance Plan

Québec Parental
Insurance Plan
Evolving with today’s parents!

Forms

Access to the service in English

Service in English is reserved for individuals covered by the exceptions stipulated in the Charter of the French language. If you have navigated to this content, you confirm in good faith that you are such an individual.

Employment information—Relevé de renseignements sur l’emploi RQAP form (French only)

You are a salaried worker whose income is not insurable under Employment Insurance but is insurable under the QPIP?

Federal and Québec income tax withheld on benefits

Request to Have Additional Income Tax Withheld at Source—Use this Revenu Québec form to request that additional income tax be withheld from your Québec Parental Insurance Plan (QPIP) benefits for Québec income tax purposes. You can send us your completed and signed form using either of the following methods: Use the QPIP’s online services to upload a digitized copy of the form or a picture of the form, or mail your form to the QPIP’s Centre de service à la clientèle.

Source Deductions Return—Use this Revenu Québec form to determine the amount to be withheld from your Québec Parental Insurance Plan (QPIP) benefits for Québec income tax purposes and the amount transferred from your spouse. You can send us your completed and signed form using either of the following methods: Use the QPIP’s online services to upload a digitized copy of the form or a picture of the form, or mail your form to the QPIP’s Centre de service à la clientèle.

Personal Tax Credits Return—Use this Canada Revenue Agency form to determine the amount to be withheld from your Québec Parental Insurance Plan (QPIP) benefits for Federal income tax purposes and the amount transferred from your spouse. You can send us your completed and signed form using either of the following methods: Use the QPIP’s online services to upload a digitized copy of the form or a picture of the form, or mail your form to the QPIP’s Centre de service à la clientèle.

Other useful forms

Power of Attorney—This Ministère de l'Emploi et de la Solidarité sociale form may be completed by a person who wishes to appoint someone else to act on his or her behalf in dealings with the Québec Parental Insurance Plan (QPIP). The completed and signed form must be mailed to the QPIP’s Centre de service à la clientèle.

Permission to Disclose Personal Information to a Third Party—This Ministère de l'Emploi et de la Solidarité sociale form must be completed in order to authorize the QPIP to disclose personal information to someone designated by the beneficiary or his or her representative. The completed and signed form must be mailed to the QPIP’s Centre de service à la clientèle.

Application for review form

If you wish to contest a decision rendered concerning your file, you must complete an application for review form and send it to us within 90 days following receipt of the decision notice.

Your application for review will be assessed on the basis of the facts available at the time the decision was rendered. You must notify us of any change in your situation that occurs after that time.

For quicker processing, use our online services.

By mail

Acrobat prints documents in letter format (8½ inches X 11 inches) by default. Since the Application for review form (PDF, 134 KB) is a legal-size document (8½ inches X 14 inches or 215 mm by 355 mm), you must adjust the desired printing format and use legal-size paper.

Please send the completed and signed form to the following address: 

Centre de service à la clientèle
19, rue Perreault Ouest, 1er étage
Rouyn-Noranda (Québec) J9X 0A1

By Internet

Access your online file, select the “Contestation of a decision” tab, enter the information concerning your application for review and submit it.

Last update: July 13, 2023