Forms
As of July 1, 2008, the Alberta government is making adjustments to the earnings exemptions for the Alberta Seniors Benefit (ASB) program and for the eligibility income thresholds for the ASB, Special Needs, Dental and Optical Assistance for Seniors programs. Learn more about the adjustments for the new benefit year.
The following forms are available in portable document format. If you do not have Adobe Reader to open portable document files, you can download it for free. Or, call the Alberta Seniors Information Line at
1-800-642-3853 and our staff will send out an application package.
Please read the information booklet or instructions before completing your application form. At this time, electronic applications cannot be accepted. Completed forms can be mailed to Alberta Seniors and Community Supports, Box 3100, Edmonton, Alberta, T5J 4W3.
Alberta Seniors Benefit Program
- Application Package
Direct Deposit- Certificate of Incapability
- Authorization of Representative
- Appeal
Special Needs Assistance For Seniors
Dental Assistance for Seniors Program
