Block 17 – Separation payments

In Block 17A, Block 17B, and Block 17C, report all payments or benefits other than regular pay that the employer has paid or will pay to the employee because of the separation.

The term separation refers to the period during which an employee experiences an interruption of earnings. The separation can be either final or not final.

It does not matter when the employer makes separation payments to an employee. For example, an employee can receive these payments or benefits:

• in the final pay period;
• any time after the employee is notified of the interruption of earnings; or
• at a later date during the interruption of earnings (regardless of whether the interruption of earnings is final or not final).

Include all separation payments in Block 17, regardless of whether these payments or benefits are considered insurable earnings.

See the Summary Chart for detailed information on what payments or benefits are considered insurable earnings.

Do not include separation payments that have not been paid due to bankruptcy.

Block 17A – Vacation pay

Enter any vacation pay the employer has paid or will pay to the employee because of the separation.

See Block 17A: Vacation pay for detailed information on the different types of vacation pay and whether to include these amounts in this block.

Block 17B – Statutory holiday pay

The term statutory holiday covers the following days:

• the actual day of the statutory holiday;
• any other day off with pay that replaces a statutory holiday (for example, if Christmas Day falls on a Sunday, an employer may give the following Monday as a day off with pay to replace the statutory holiday); or
• any designated floater days, which are additional days off with pay that are taken at a time agreed to by the employee and the employer.

In Block 17B, report the amount you paid or will pay for each statutory holiday that falls after the date in Block 11, as well as the date of each statutory holiday.

Do not include any statutory holidays that occurred before this date.

Remember to include any amounts you report in Block 17B in the totals you enter in Block 15B and in the “P.P. 1″ field of Block 15C, if necessary.

Note

If you are using a paper ROE and you have more than three statutory holidays to report in Block 17B, enter the additional information in Block 18. If you are using an electronic ROE, there are 10 fields available.

Block 17C – Other monies

In Block 17C enter any other payments or benefits other than vacation pay (Block 17A) or statutory holiday pay (Block 17B) that the employer has paid or will pay to the employee because of the separation, whether or not the amount is considered as insurable earnings.

See Block 17: Other monies for information on the types of payments that are entered in this field.

You may wish to review the tutorial, Completing the Record of Employment form: Recommended order, for an overview of the entire process.

Block 1 – Serial number

For paper ROEs, the pre-filled serial number appears in Block 1.

For electronic ROEs, Service Canada assigns serial numbers when it receives them. No action is required by employers. It may be helpful to keep track of the serial number in case you need to amend a ROE later.

Note

It is important to keep records of the serial numbers of all completed or destroyed paper ROEs for six years. Service Canada automatically keeps serial numbers of electronic ROEs.

Block 2 – Serial number of ROE amended or replaced

For paper ROEs, complete this block if you are issuing an amended ROE to change or correct information you provided on an original ROE. Enter the serial number of the original ROE in Block 2.

This field is not available for electronic ROEs.

Tip

When you issue an amended ROE, make sure to complete the entire form and re-enter all of the correct information from the original ROE, and not just the changed information.

Block 3 – Employer’s payroll reference number

Block 3 is optional. You can enter the number you are using to identify the employee in your payroll records.

Block 4 – Employer’s name and address

In Block 4 enter the employer’s name and address, except the postal code.

Tip

Use the same name and address that appear on the Canada Revenue Agency remittance form you use to report payroll source deductions.

Block 5 – CRA Business Number (Payroll Account Number)

In Block 5 enter the Canada Revenue Agency Payroll Account Number (formerly called the Business Number) you use to report the employee’s payroll deductions to the Canada Revenue Agency. The Payroll Account Number consists of nine numbers, followed by two letters, followed by four numbers. You must enter all 15 characters.

Notes

If you have an employee who is working in two or more positions at the same time, you may have assigned different Payroll Account Numbers to those positions.

If the employee experiences an interruption of earnings in all positions, you can issue one ROE combining all the payroll information. If you cannot combine all of the information, you can issue separate ROEs for each Payroll Account Number.

Block 6 – Pay period type

In Block 6 enter the pay period type for the employee. There are five standard types of pay period: weekly, biweekly, semi-monthly, monthly, or 13 pay periods a year.

If your semi-monthly or monthly pay periods are non-standard (that is, they do not end on the fifteenth or the last day of the month), please enter “non-standard semi-monthly” or “non-standard monthly” in this block.

Note

A ROE should only contain one pay period type. Refer to the guide, How to Complete the Record of Employment Form, if your pay period type has changed or if you require more information.

Block 7 – Employer’s postal code

Enter the employer’s postal code in Block 7.

Block 8 – Social Insurance Number

Enter the employee’s nine-digit Social Insurance Number (SIN) in Block 8.

Notes

It is very important to enter the correct SIN on a ROE. We cannot process a claim for EI benefits without it.

Social Insurance Numbers that begin with a 9 are temporary numbers. Check with your employee to see if they have since received a permanent number. If they have, enter the permanent number here.

Block 9 – Employee’s name and address

Enter the employee’s name (first name and initials, followed by the family name) and address, including the postal code in Block 9.

Block 10 – First day worked

Enter the employee’s first day of work for which he or she received insurable earnings in Block 10.

If you previously issued a ROE for that employee, the date you enter in Block 10 is the first day the employee worked after the last interruption of earnings (since the last ROE was issued).

Note

The date you enter in Block 10 is not necessarily the day the employee was hired, unless the employee worked on that day. The first day worked must be a day when the employee worked and received insurable earnings.

Block 11 – Last day worked

Enter the last day for which the employee received insurable earnings. This date usually coincides with the last day of work in Block 11.

Sometimes employees continue to receive insurable earnings after their last day of work. This occurs with paid leave such as vacation or sick leave, earned days off, or salary continuance. In these cases, enter the last day of paid leave in Block 11, not the last day worked (ensuring that the last day paid is not a statutory holiday).

If the employee receives a salary continuance as part of a severance package, do not issue a ROE until the end of the salary continuance period. In Block 11, enter the last day of the salary continuance period, not the last day worked.

Notes

When unpaid wages are owing to an employee on separation because of the employer’s bankruptcy, receivership, or impending receivership, you must enter the last day for which these wages are owed.

If an employee was on paid sick leave, additional information is included in Block 19.

Block 12 – Final pay period ending date

In Block 12, enter the end date of the final pay period that includes the date you entered in Block 11. The date in Block 11 and the date in Block 12 will usually be different, except when the employee’s last day paid corresponds to the last day of the pay period. Please note that the date in Block 12 can never be earlier than the date in Block 11.

Note

When using the weekly averaging formula, use the Saturday of the week that contains the last day for which paid as the date to enter in Block 12.

Block 13 – Occupation (optional)

Enter an accurate description of the employee’s main occupation (for example, sales clerk, graphic designer, construction labourer, legal assistant) in Block 13.

Block 14 – Expected date of recall (optional)

If the employee will be returning to work and you know the expected return date, enter it in Block 14. If you do not know the return date, check the Unknown box. If the employee will not be returning to work, check the Not returning box.

Block 15A – Total insurable hours

Enter the employee’s total insurable hours.

To determine if hours are insurable, see Annex 1 of the guide, How to Complete the Record of Employment Form.

For detailed instructions on Blocks 15A, see the online tutorial, Block 15 – Insurable hours and earnings.

Block 15B – Total insurable earnings

Enter the employee’s total insurable earnings.

To determine if earnings are insurable, see the chart in Annex 1 of the guide, How to Complete the Record of Employment Form.

For detailed instructions on Block 15B, see the online tutorial, Block 15 – Insurable hours and earnings.

Block 15C – Insurable earnings by pay period

The first entry must record the insurable earnings for the final (most recent) insured pay period.

Enter details by pay period according to the chart in Annex 1 of the guide, How to Complete the Record of Employment Form.

Requirements for Block 15C differ for paper and electronic ROEs. See the online tutorial, Block 15 – Insurable hours and earnings for detailed information and instruction.

Block 16 – Reason for issuing this ROE

In Block 16, enter the code that best corresponds to the reason for issuing the ROE.

Also in Block 16, you must enter the full name and telephone number of the person in your organization who is available to provide more information or clarification about the reason for issuing the ROE, should Service Canada require it.

Note

Code K – Other should only be used in exceptional circumstances.

Block 17 – Separation payments

In Block 17A, Block 17B, and Block 17C, report all payments or benefits other than regular pay that the employer has paid or will pay to the employee because of the separation.

The term separation refers to the period during which an employee experiences an interruption of earnings. The separation can be either final or not final.

For detailed instructions on Blocks 17A, 17B, and 17C, see the online tutorial, Block 17 – Separation payments.

Block 18 – Comments

Enter any specific details in Block 18 about exceptional circumstances you would like to communicate to Service Canada to help clarify the information on the ROE.

Please do not include comments that only confirm information you have entered elsewhere on the form.

Note

With electronic ROEs, if you include a comment in Block 18, it triggers a manual review, which slows ROE processing.

For more information on completing Block 18, please consult the guide, How to Complete the Record of Employment Form.

Block 19 – Paid sick/maternity/parental/compassionate care leave or group wage loss indemnity payment

You only need to complete Block 19 if the employee received any sick leave, maternity leave, parental leave, compassionate care leave, or group wage-loss insurance payments from the employer, or if the employee is receiving any group wage-loss indemnity plan payments from a third party.

See the guide, How to Complete the Record of Employment Form, for detailed information on what to report in Block 19.

Block 20 – Language

Indicate whether your organization prefers to communicate in English or French in Block 20.

Block 21 – Telephone number of issuer

Enter the full 10-digit telephone number of the person who is able to answer questions from Service Canada about the information entered on the ROE in Block 21.

Block 22 – Certification

In Block 22, the person who is completing the ROE certifies that the information on the form is correct with his or her name and the date on which the ROE is issued.