IMM 5563E: ACCESS TO INFORMATION AND PERSONAL INFORMATION ...€¦ · 2. Consent(s) - If you are...
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Citizenship and Immigration Canada Citoyenneté et Immigration Canada PAGE 1 OF 2 IMM 5563 (05-2012) E ACCESS TO INFORMATION AND PERSONAL INFORMATION REQUEST IMPORTANT - PLEASE READ THE FOLLOWING If using this request form, please do not accompany it with a letter or the Treasury Board Secretariat (TBS) forms. Only provide us with this form, the necessary consent forms and the fees (if applicable) when making a request. BASIC ITEMS NEEDED TO START PROCESSING A REQUEST: 1. Formal request 2. Consent(s) - If you are requesting personal information that is not your own, you must include a consent to release the information. The consent must be dated and signed by the person authorizing the disclosure of their information to a third party. 3. Fee ($5.00, required for an Access to Information request). You can pay by credit card, cheque or money order. For payments by credit card, please pay your fees online at http://www.cic.gc.ca/english/information/fees/index.asp . If you pay by... Then... credit card online include a copy of your receipt as proof of payment with your request. cheque or money order it must be made payable to the Receiver General for Canada (name and address must be printed on the cheque, so that it can be traced if requested). SECTION A - DETAILS OF REQUEST Check off the appropriate boxes to indicate: 1. The Act under which you are making a request 2. Language for record delivery (The information recorded by the officer will not be translated, only the system interface will be in the language of your choice.) 3. Format for record delivery 4. Requesting information for another individual? You can access the Use of Representative form at the following link: http://www.cic.gc.ca/english/information/applications/representative.asp or the Authority to Release Personal Information to a Designated Individual form at the following link: http://www.cic.gc.ca/english/information/ applications/release-info.asp . Please note that we cannot disclose personal information about a person who has been deceased less than 20 years. An exception can be made in some cases (to execute a will or obtain certain benefits, for example). You must provide a detailed account of your situation, as well as proof of death, so that we can determine whether an exception can be made. A death certificate, an obituary or a photograph of the person's headstone constitutes proof of death. If you are making a request for information about another individual whose consent you do not have, the request will be considered individually to determine whether the information can be released in accordance with paragraph 19(2) of the Access to Information Act. SECTION B - INFORMATION REQUESTED Provide the name, aliases and date of birth of the person whose information you wish to obtain. If you are requesting information for an entire family, you are only required to submit one request form to obtain an immigration file; but be sure to include the appropriate consents from each person over the age of 18. Select the types of records that you are seeking. For the record(s) requested, please provide your file number and/or client identification number and location. Choose from the following options: (1) Electronic files: Citizenship and Immigration Canada (CIC) uses three electronic systems (abroad and in-Canada) to process applications for citizenship and immigration services. To obtain the status of a file, the electronic files may be sufficient. Requests for electronic files can be processed more quickly than requests for physical files that are held at missions abroad, which can increase the processing time. Remember that processing times vary from case to case. (2) Physical files: Physical files include all files located in Canada or abroad that pertain to an immigration process. If you wish to obtain a medical file, be sure to check the appropriate box on the form. X-rays will not be provided with the medical file. If you wish to obtain the permanent resident card application, be sure to check the appropriate box on the form. The permanent resident card application does not include the actual permanent resident application form. If you wish to obtain the citizenship and naturalization files, be sure to check the appropriate box on the form. Note: Most file numbers found in visa files and electronic files have seven digits, preceded by a B, V, W, S, E, or F. SECTION C - REQUESTER'S CONTACT INFORMATION Requests under the Access to Information Act and the Privacy Act can only be made by Canadian citizens, permanent residents of Canada or persons present in Canada. If you do not fall within one of these categories, your request must be made under the Access to Information Act through a representative who has right of access. Your first request must include proof of Canadian citizenship, permanent residence or presence in Canada (i.e. a copy of your Canadian passport or your Immigration Consultants of Canada Regulatory Council (ICCRC) number). Note: Landing records will not be provided. To request a landing record, please visit the following link: http://www.cic.gc.ca/english/information/ applications/certcopy.asp . You may also contact the Citizenship and Immigration Canada Call Centre at 1-888-242-2100. For more information about access to information and privacy, you can visit the Citizenship and Immigration Canada Web site at http://www.cic.gc.ca/english/department/atip/index.asp .
Transcript of IMM 5563E: ACCESS TO INFORMATION AND PERSONAL INFORMATION ...€¦ · 2. Consent(s) - If you are...
Citizenship and Immigration Canada
Citoyenneté et Immigration Canada
PAGE 1 OF 2
IMM 5563 (05-2012) E
ACCESS TO INFORMATION AND PERSONAL INFORMATION REQUEST
IMPORTANT - PLEASE READ THE FOLLOWING
If using this request form, please do not accompany it with a letter or the Treasury Board Secretariat (TBS) forms. Only provide us with this form, the necessary consent forms and the fees (if applicable) when making a request.
BASIC ITEMS NEEDED TO START PROCESSING A REQUEST:1. Formal request 2. Consent(s) - If you are requesting personal information that is not your own, you must include a consent to release the information. The consent
must be dated and signed by the person authorizing the disclosure of their information to a third party. 3. Fee ($5.00, required for an Access to Information request). You can pay by credit card, cheque or money order. For payments by credit card,
please pay your fees online at http://www.cic.gc.ca/english/information/fees/index.asp.
If you pay by... Then...
credit card online include a copy of your receipt as proof of payment with your request.
cheque or money order it must be made payable to the Receiver General for Canada (name and address must be printed on the cheque, so that it can be traced if requested).
SECTION A - DETAILS OF REQUEST
Check off the appropriate boxes to indicate:
1. The Act under which you are making a request
2. Language for record delivery
(The information recorded by the officer will not be translated, only the system interface will be in the language of your choice.)
3. Format for record delivery
4. Requesting information for another individual? You can access the Use of Representative form at the following link: http://www.cic.gc.ca/english/information/applications/representative.asp or
the Authority to Release Personal Information to a Designated Individual form at the following link: http://www.cic.gc.ca/english/information/applications/release-info.asp.
Ø Please note that we cannot disclose personal information about a person who has been deceased less than 20 years. An exception can be made in some cases (to execute a will or obtain certain benefits, for example). You must provide a detailed account of your situation, as well as proof of death, so that we can determine whether an exception can be made. A death certificate, an obituary or a photograph of the person's headstone constitutes proof of death.
Ø If you are making a request for information about another individual whose consent you do not have, the request will be considered individually to determine whether the information can be released in accordance with paragraph 19(2) of the Access to Information Act.
SECTION B - INFORMATION REQUESTED
Provide the name, aliases and date of birth of the person whose information you wish to obtain. If you are requesting information for an entire family, you are only required to submit one request form to obtain an immigration file; but be sure to include the appropriate consents from each person over the age of 18. Select the types of records that you are seeking. For the record(s) requested, please provide your file number and/or client identification number and location. Choose from the following options: (1) Electronic files: Ø Citizenship and Immigration Canada (CIC) uses three electronic systems (abroad and in-Canada) to process applications for
citizenship and immigration services. Ø To obtain the status of a file, the electronic files may be sufficient. Requests for electronic files can be processed more quickly than
requests for physical files that are held at missions abroad, which can increase the processing time. Remember that processing times vary from case to case.
(2) Physical files: Ø Physical files include all files located in Canada or abroad that pertain to an immigration process. Ø If you wish to obtain a medical file, be sure to check the appropriate box on the form. X-rays will not be provided with the medical file. Ø If you wish to obtain the permanent resident card application, be sure to check the appropriate box on the form. The permanent
resident card application does not include the actual permanent resident application form. Ø If you wish to obtain the citizenship and naturalization files, be sure to check the appropriate box on the form. Note: Most file numbers found in visa files and electronic files have seven digits, preceded by a B, V, W, S, E, or F.
SECTION C - REQUESTER'S CONTACT INFORMATION
Requests under the Access to Information Act and the Privacy Act can only be made by Canadian citizens, permanent residents of Canada or persons present in Canada. If you do not fall within one of these categories, your request must be made under the Access to Information Act through a representative who has right of access. Your first request must include proof of Canadian citizenship, permanent residence or presence in Canada (i.e. a copy of your Canadian passport or your Immigration Consultants of Canada Regulatory Council (ICCRC) number). Note: Landing records will not be provided. To request a landing record, please visit the following link: http://www.cic.gc.ca/english/information/
applications/certcopy.asp. You may also contact the Citizenship and Immigration Canada Call Centre at 1-888-242-2100.
For more information about access to information and privacy, you can visit the Citizenship and Immigration Canada Web site at http://www.cic.gc.ca/english/department/atip/index.asp.
Citizenship and Immigration Canada
Citoyenneté et Immigration Canada
IMM 5563 (05-2012) E
PAGE 2 OF 2 PROTECTED WHEN COMPLETED - B
ACCESS TO INFORMATION AND PERSONAL INFORMATION REQUEST
SECTION A - DETAILS OF REQUEST1. Please select the Act under which you are submitting this request:
Note: If you are submitting a request under the Access to Information Act, you must include the $5.00 application fee.
Access to Information Act Privacy Act
2. In which language do you wish to receive the requested records:
English French
3. How do you wish to receive the records?
Note: An extension may be needed to convert the information to an alternative format.
E-mail CD Paper format Examine in person
4. Are you requesting information on your own behalf?
Note: If no, you must include a consent to release the information.
Yes No
FOR OFFICE USE ONLY
SECTION B - INFORMATION REQUESTED
Family name (surname) Given name(s) - (including aliases) Date of birth (YYYY-MM-DD)
Electronic files
File number
Client ID number Location
Client ID number
File number
File number Location
Physical filesFile number Location
Client ID number Location
File number Location
Client ID number
File number Date of death (if applicable) (YYYY-MM-DD) Proof included
Citizenship file
Immigration file in Canada
Immigration file overseas
Immigration file in Canada
Medical file
Permanent resident card application
Citizenship/naturalization files
Permanent residenceTemporary residence
Permanent residenceTemporary residence
Status of an application
Reason for refusalor
SECTION C - REQUESTER'S CONTACT INFORMATION
• All correspondence will go to this address unless you indicate your e-mail address below. • Indicating an e-mail address will authorize all correspondence, including file and personal information, to be sent to the e-mail address you specify.
This request is submitted by a Canadian citizen, a permanent resident or a person present in Canada Immigration Consultants of Canada Regulatory Council (ICCRC) number
Mr. Mrs. Ms.Family name (surname) Given name(s)
Apt/Unit Street no. Street name City/Town Province Postal code
Telephone number (including area code)
Fax number (including area code)
Requester's signature Date (YYYY-MM-DD)
The information you provided on this form is collected under the authority of the Access to Information Act and the Privacy Act and will be used to administer these acts as well as the process and to respond to requests. This information may also be used during consultations with other government institutions during investigations by the Offices of the Information and Privacy Commissioners and during court reviews. It will be retained in Personal Information Bank CIC PSU 901 - Access to Information and Privacy Requests. It may be shared with other organizations in accordance with the consistent use of information under the Privacy Act. Pursuant to the Privacy Act and the Access to Information Act, individuals have the right to protection of and access to their personal information. Details of these matters are available at infosource.gc.ca and through the Citizenship and Immigration call centre. Info Source is also available at public libraries in Canada.
Completed forms must be sent to the following address: Access to Information and Privacy Division
Citizenship and Immigration Canada Ottawa, Ontario K1A 1L1
or by e-mail to [email protected]
