INSTRUCTIONS:

  • Fill out and return this form to be reimbursed for purchase of services.
  • Attach official receipts / invoices as proof of purchase.
  • Incomplete invoice forms will not be processed and will delay payment.
  • If you have questions about the invoice, payment processing, or require any support, please contact your local Passport Agency.


SIGNATURE - PERSON MANAGING FUNDS

By signing this form, I acknowledge that:
I authorize Community Living Toronto, and its partner Darts Solutions Inc., to collect and submit the information on this form on my behalf to Family Services Toronto PassportONE and my local Passport Agency for payment processing and reimbursement.

Signature of Person Managing Funds (Download signature file and put your signature then upload it) Download Sign file

Date: