Who should complete the Residency Statutory Declaration?
- Individuals who have moved to the NWT and intend to stay here for more than a year, but can’t provide two documents that show that they live here.
- Individuals leaving the NWT for long winter vacations.
Completing the Residency Statutory Declaration
- Complete and submit the Residency Statutory Declaration with the appropriate application form (Applying for NWT Health Care or Temporary Absence Form).
To maintain your health coverage, submit a Temporary Absence Form if you plan to be outside of the NWT for more than 90 days.
- Residency Statutory Declaration
Available at the Health Services Administration Office.
- There is no fee.
Contact this Service
Phone: 1-800-661-0830 (toll free)
Hours: 9:00 AM – 4:30 PM (Monday to Friday, closed statutory holidays)
Sending the Completed Form…
Health Services Administration
Department of Health and Social Services
Inuvik, NT X0E 0T0
Fax to: 1-867-777-3197
Email to: email@example.com