How to submit LTC benefit-transition support documents — and autofill 014-4817-69 with my-id.ca
Attach co-payment documents after a benefit change without retyping resident details
Long-term care homes and residents who transitioned between Ontario benefits repeat the resident's name, health number, home name, and representative contact when submitting a notice of assessment and the support document list for co-payment reassessment. This guide is an example of storing them once in my-id.ca.
Official form and source
Start from the official source and always use the current version — form numbers and links can change:
- Service page: Paying for long-term care — ontario.ca
- Form (Central Forms Repository): Long-Term Care Home Support Document List - Submitting NOA that included benefit(s) that a resident is no longer receiving because they have transitioned to new benefit(s) — 014-4817-69
What this form is about
Form 014-4817-69 is the Long-Term Care Home Support Document List for residents submitting a notice of assessment that included benefits they no longer receive because they transitioned to new benefits, used when reassessing basic accommodation charges.
Before you start: what to gather
- Resident full legal name and Ontario health number.
- Long-term care home name and address.
- Notice of assessment and documents for the new benefit — confirm list on ontario.ca.
- Representative name and contact if someone signs on the resident's behalf.
Confirm the current process on ontario.ca.
How my-id.ca makes it faster
- Save it once. Store your resident name, health number, and home contact details in your my-id.ca profile.
- Keep documents ready. Upload supporting documents to my-id.ca Files so you are not searching at form time.
- Autofill the form. Use the my-id.ca Chrome extension on a web form, or fill a PDF from your saved profile inside my-id.ca.
- Review and submit yourself through the official channel.
Why do it in my-id.ca
Related Ontario forms repeat the same personal details. Captured once in my-id.ca — stored in Canada, with AI on its own servers — every form starts mostly complete.
Frequently asked questions
- How is this different from form 014-4818-69?
- 014-4818-69 is for residents receiving ODSP; 014-4817-69 covers residents who transitioned between benefits.
- How does my-id.ca help?
- It autofills resident health numbers and LTC home contact details across co-payment forms.
- Where do I submit the documents?
- Return through your long-term care home as directed for co-payment assessment.
Fill it once. Reuse it everywhere.
Save your information in my-id.ca once, then autofill this form and the next one — web forms with the Chrome extension, PDFs right in the app. Your data is stored in Canada and AI runs on my-id.ca's own servers, never sent to third-party AI providers.