Multiple Youth-Based Voucher Pilot

Introduction:

Please fill out this form to apply for the Town of Innisfil's "Multiple Youth-Based Voucher" pilot program for families with more than one child or teen. This application will help us assess your eligibility for the pilot to use Uber through Innisfil Transit.

To participate in the pilot, you must:

• live in Innisfil;
• need rides within Innisfil Transit's service area; and
• be travelling with multiple youth (under 18 years old) for whom you are responsible.

This voucher helps families who need to bring more than one child, since regular Innisfil Transit trips have a two-seat limit. It lets a parent or guardian travel with more children or teens to or from an Innisfil Transit Hub using their Uber account.

The pilot program runs until the end of 2025. Up to 15 trips can be booked each month by one member of a household. Only one voucher will be permitted per household.

Before filling out this form, please ensure that you have an electronic copy of the following documents to upload with your application:

• Proof of Residence (one of the following):
  • Photocopy of driver's licence
  • Photocopy of recent utility bill
  • Municipal tax bill
  • Other official document with your name and address
• Most recent Child Tax Benefit or HST Notice (if applicable)

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Applicant Information

Full Name
	last name	first name

Email Address on Uber Account
Phone Number on Uber Account
Home Address (Must be in Innisfil)

Proof of Residence

Please Upload one of the following: Photocopy of licence Photocopy of recent utility bill Municipal tax bill Other official document containing your name and address

Child Tax Benefit

If applicable, upload a copy of your most recent Child Tax Benefit or HST Notice (pages 1 and 2) for all dependents

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By checking this box, the Applicant declares that all information provided is true to the best of their knowledge. The Applicant further acknowledges that providing any false information on this form may result in the request being denied. The Applicant also acknowledges that the Town reserves the right to withdraw vouchers from successful applicants due to a lack of usage or misuse of the vouchers.

If you have any questions regarding administrative aspects of this form, please contact Customer Service at inquiry@innisfil.ca or 705-436-3710.

Upon receiving this application, the Town will make best efforts to provide a written response to the Applicant within 5 business days. In assessing the application, the Town may contact the Applicant for further information.

Personal information collected on this form is pursuant to the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, Chapter M.56, as amended, and will be used to process the application for the Multiple Youth-Based Voucher Pilot Program. Information may also be used for administration and to ensure compliance with the approved voucher. Information may be disclosed to Uber for the purpose of applying a voucher to an Uber account if approved. Questions about this collection should be directed to: Clerk's Office, Town of Innisfil, 2101 Innisfil Beach Road, Innisfil ON, L9S 1A1, 705-436-3710 or emailed to clerksoffice@innisfil.ca.