COVID-19 paid sick-leave reimbursement application

Business Legal Name: 900152 BC LTD
Trade Name: Peter's Pizza Mamma Mia
Employer Account Number: 987654321
Mailing address: 123 MAIN ST, VANCOUVER BC, V7M 0B9
Employer contact phone number: 604-555-888
Employer email address:
Employer/Business type: Corporation

You are set up for direct deposit for this reimbursement

This reimbursement will be deposited into your bank account.

Step 2: Enter employee's details

Employers are only eligible for reimbursement if an employee's leave is due to a COVID-19 related circumstance and the leave was taken between May 20, 2021 and December 31, 2021. Find out more about eligibility.

Please enter the employee’s information below and be sure to complete all fields. You’ll have a chance to review your application before submitting it. To add another employee, select “Add employee” below.

Please provide a valid claim number
Please provide a valid claim number




Total: $350.00

Joe Doe has been succesfully added
Joe Doe has been removed

Employees added for reimbursement

The following is a list of the employees who are included in your sick-leave reimbursement application.

Employee SIN Day 1 Day 2 Day 3 Total
Joe Doe *** *** 123 $100 $100 $100 $300.00 Edit Remove
Matt Gregor *** *** 456 $100 $100 $100 $200.00 Edit Remove
Jane Willis *** *** 456 $100 $100 $100 $100.00 Edit Remove

Your total reimbursement amount is $600

This reimbursement will be deposited into your bank account.
Done adding employees

Have a question about this COVID-19 paid sick leave reimbursement application?
We're here to help, please call us at 1.844.778.2200 or email us at: