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TPA Notification form

If a client has decided to sign on with your agency you must complete a Notification of Transfer Payment Agency Form, which must be signed by the clients Person Managing Funds (PMF) and a signing authority at your agency.

Download the Notification of Transfer Payment Agency Form here.


Dissolution Form

If you decide to dissolve your relationship with a client, or they with you, the following is required:

  1. The Person Managing Funds (PMF) must sign the Dissolution section on the back of the notification form they signed to register with your agency, or the Dissolution Notification Form, and email this to with 30 days notice.
  2. You must submit any outstanding claims in a timely fashion.

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Hamilton, ON, L8N 1B2
Phone: 905-570-8888