Shelter Allowance Application
LEX-165-V

Complete this form if you want to receive (or continue receiving) the shelter allowance for the period from October 1, 2022, to September 30, 2023.

Check the eligibility requirements and see guide LEX-165.G-V, Information Concerning the Shelter Allowance, for help completing this form.

You may have to provide the following forms with your application:

  • Statement of Rent – 2022 (LEZ-14-V), if you are a tenant, you live in the home of someone who is an owner or a tenant, or you live in a mobile home on rented land;
  • Request for Direct Deposit (LEZ-15-V), if you want to sign up for direct deposit.

Use our Checklist (LEX-170-V) to make sure you provide all the right documents with your application.

You must inform us right away if, between the time you submit your application and October 1, 2023:

  • you move into subsidized housing;
  • you and your spouse separate;
  • you leave Québec; or
  • you are confined to a prison or similar institution.
Note

To complete the form, save it to your computer and open it in Adobe Reader.

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Note

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2022-09 version

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