"Separation Declaration Form - Parents of Dependent Students" - Saskatchewan, Canada

This Saskatchewan-specific printable "Separation Declaration Form - Parents of Dependent Students" is a part of the legal paperwork issued by the Saskatchewan Ministry of Education.

Download the up-to-date PDF by clicking the link below and mail it as per the guidelines provided by the department.

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Download "Separation Declaration Form - Parents of Dependent Students" - Saskatchewan, Canada

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In the matter of the Saskatchewan Student Aid Fund; and in the matter of a Student Loan Application
Separation Declaration
Student Service Centre
1120 - 2010 12th Avenue
Regina, Canada S4P 0M3
306-787-5620
Parents of Dependent Students
1-800-597-8278
Fax: 306-787-1608
For Office Use Only
File No.
Student’s Post-Secondary
Student’s Full
Education No.: __________________________
Name
: ______________________________________
(please print)
I, ____________________________________________________, of ________________________, ________________.
(Full name of parent)
(City/Town/Village)
(Province)
Declare that
1. I was married to, or was living common-law with ____________________ on/from the ___ day of _____, 20___
(name of former spouse)
at _____________________________________. There are ______ children of the marriage, namely:
(city and province)
________________________________________________________________________________________________.
(names of all children)
2. I began living seperate and apart from my said spouse on or about the _____ day of ________, 20____, and
have continued to live separate and apart from my said spouse since that date.
3. Effective the _____day of _______, 20_____, at the start date of my course, I have (check one):
… full-time custody of my children who will be living with me full-time, or
… 50% custody, or
… less than 50% custody,
of the following children: ______________________________________________________________________
Please indicate Yes or No to question 4 through 7.
4. (a) Do you have a written separation agreement between yourself and your spouse?
 Yes  No
If yes: What is the amount per month you receive for child support/alimony under this agreement? $______
per month (Attach a copy of this written agreement to this Declaration)
(b) Do you have an oral separation agreement between yourself and your spouse?
 Yes  No
If yes: What is the amount per month you receive for child support/alimony under this agreement? $______
per month
5. Are you paying child support?
 Yes  No
If yes: What is the monthly amount you pay? $______ per month
Date these payments came into effect the ____ day of _______, 20_____
6. Were there assests which were divided between yourself and your spouse?
 Yes  No
If yes: Attach a list of the division of assests.
7. Are you co-habitating (living common-law) at the present time?
 Yes  No
If yes: Indicate the full name of common-law spouse _____________________________________
8. I declare that the said separation is due to marital breakdown and not geographic location or other reasons.
And I make this Declaration conscientiously, believing it to be true, and knowing it is of the same force and
effect as if made under Oath and by virtue of the Canada and Saskatchewan Evidence Acts.
X ______________________________
____________________________
Signature of Student
Date
saskatchewan.ca/studentloans | 1-800-597-8278
AI024-0614
In the matter of the Saskatchewan Student Aid Fund; and in the matter of a Student Loan Application
Separation Declaration
Student Service Centre
1120 - 2010 12th Avenue
Regina, Canada S4P 0M3
306-787-5620
Parents of Dependent Students
1-800-597-8278
Fax: 306-787-1608
For Office Use Only
File No.
Student’s Post-Secondary
Student’s Full
Education No.: __________________________
Name
: ______________________________________
(please print)
I, ____________________________________________________, of ________________________, ________________.
(Full name of parent)
(City/Town/Village)
(Province)
Declare that
1. I was married to, or was living common-law with ____________________ on/from the ___ day of _____, 20___
(name of former spouse)
at _____________________________________. There are ______ children of the marriage, namely:
(city and province)
________________________________________________________________________________________________.
(names of all children)
2. I began living seperate and apart from my said spouse on or about the _____ day of ________, 20____, and
have continued to live separate and apart from my said spouse since that date.
3. Effective the _____day of _______, 20_____, at the start date of my course, I have (check one):
… full-time custody of my children who will be living with me full-time, or
… 50% custody, or
… less than 50% custody,
of the following children: ______________________________________________________________________
Please indicate Yes or No to question 4 through 7.
4. (a) Do you have a written separation agreement between yourself and your spouse?
 Yes  No
If yes: What is the amount per month you receive for child support/alimony under this agreement? $______
per month (Attach a copy of this written agreement to this Declaration)
(b) Do you have an oral separation agreement between yourself and your spouse?
 Yes  No
If yes: What is the amount per month you receive for child support/alimony under this agreement? $______
per month
5. Are you paying child support?
 Yes  No
If yes: What is the monthly amount you pay? $______ per month
Date these payments came into effect the ____ day of _______, 20_____
6. Were there assests which were divided between yourself and your spouse?
 Yes  No
If yes: Attach a list of the division of assests.
7. Are you co-habitating (living common-law) at the present time?
 Yes  No
If yes: Indicate the full name of common-law spouse _____________________________________
8. I declare that the said separation is due to marital breakdown and not geographic location or other reasons.
And I make this Declaration conscientiously, believing it to be true, and knowing it is of the same force and
effect as if made under Oath and by virtue of the Canada and Saskatchewan Evidence Acts.
X ______________________________
____________________________
Signature of Student
Date
saskatchewan.ca/studentloans | 1-800-597-8278
AI024-0614