CONSENT FOR AN ACCESS TO INFORMATION AND
PERSONAL INFORMATION REQUEST

Complete this form if you authorize the Access to Information and Privacy (ATIP) Division at Immigration, Refugees and Citizenship Canada (IRCC) to release your personal information to someone other than yourself.

Please be advised that you must submit a separate consent form for each individual in your file over the age of 18 if you wish to receive their information as well.

  • Section 1
  • Section 2
  • Section 3
  • Section 4

Section A

Tell us something more about you

Section B

If you are also seeking the information of your spouse or common-law partner in your ATIP request, you must indicate their name and signature

Section C

You must write your designated individual's contact information

Have you visited/ or ever have lived in Canada? No Yes

Section D

If the applicant is under 18 years of age, the parent or guardian must complete this section

accepts terms and condition of service

Choose Payment Method :

Indian Credit & Debit Cards are accepted