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Home  Virtual Exhibits Resettlement Documents Application for Assistance
Application for Assistance
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NEWFOUNDLAND DEPARTMENT OF FISHERIES
Fisheries Household Resettlement Division
APPLICATION for assistance under the Household Resettlement Division to move from
____________________________ to ___________________________.
(When completed this form should be mailed to the Director of Household Resettlement Division).
1. I,_________________________________________________________________________
(Surname of Householder) (Christian name in full)
(Sex)
2. Present Address:___________________________________________________________
(Full Postal Address)
3. My name appears on the original Petition for assistance under the Fisheries
Household Resettlement Program. ____________________
4. Date of birth of householder _____________ of spouse______________
Marital Status ________________.
5. Father's name _______________ Mother's name _______________
6. My household is made up of ____ members. This number includes:
(a) My spouse ________________________________
(name)
(b) Children: Living at Home Ages Living at Home Ages
__________________________ ________________________
__________________________ ________________________
__________________________ ________________________
__________________________ ________________________
__________________________ ________________________
(c) Others: Name
Relationship
__________________________ ________________________
__________________________ ________________________
7. (a) I have lived in the place vacated all my life ________, or moved there on
the ________ day of _______ 19___.
(month)
(b) I moved from _________________________ to ___________________________ on
the ________ day of _______ 19___.
(month)
8. State: (a) Occupation prior to resettlement ___________________
(b) Present or intended occupation ___________________
(c) Any other occupation in which you have had work
experience or training ___________________
(d) Occupation of your spouse ___________________. Training
or work experience of your spouse ___________________
9. I was the owner of and occupied as the head of the household a dwelling in
_____________________________.
(name of community abandoned)
10. I was the owner of livestock. __________ Explain _____________________________________
I,......................................................, solemnly declare that I am the
(name of applicant)
applicant named above, that all the statements contained in the
foregoing application are true to the best of my knowledge and
belief, and that no information has been concealed or omitted.
I make this solemn declaration conscientiously believing it to be
true and knowing that it is of the same force and effect as if
made under oath by virtue of the “Canada Evidence Act”.
Declared before me at .......................
this ........ day of ........ 19 ...
having been first carefully read over by the
applicant (or to the applicant by me) when
he appeared to understand the same perfectly.
...................................................................................
..........................................
Signature of Magistrate, Justice of the Peace,
Signature of applicant
Notary Public, or other person authorized to
administer oaths in Newfoundland.
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