T01 Application for the Release of Information made by a Provincial Enforcement Service

Protected B when completed

(Section 15 of the Family Orders and Agreements Enforcement Assistance Act (the Act))

Important notice: If you are applying on behalf of a Provincial Child Support Service, a Designated Authority or a Central Authority in your jurisdiction, this is not the correct form. Please complete the form created for the appropriate entity.

Part 1: Provincial Enforcement Service Identification
Part 2: Information concerning the person in respect of whom information is requested
Part 3: Purpose of the application and information being requested

I. Purpose of the Application
Check the purpose for which the information is being requested (item A, B, or C)

II. Information being requested related to the person named in Part 2 of this application
Check only the information required for the purpose of this application

Part 4: Declaration

I declare that the information in this application is correct and that the information was provided for the purpose of applying for the release of information under Part I of the Act.

Privacy Act Notice Statement

The Department of Justice Canada is committed to protecting the privacy of individuals, including safeguarding the personal information you provide on this Application form. The personal information provided on this form is collected under the authority of the Family Orders and Agreements Enforcement Assistance Act and the Release of Information for Family Orders and Agreements Enforcement Regulations and is protected in accordance with the Privacy Act (PA). This information will be used and retained to respond to this request and for any other uses or disclosures in accordance with the PA.

Under the PA, you have the right to access your personal information retained by the Department of Justice Canada and request corrections to it. Where correction is not possible, you have the right to request that a notation be attached to the information reflecting any correction requested but not made. If you require clarification about this PA Notice Statement, please contact our Access to Information and Privacy Office at ATIP-AIP@justice.gc.ca or by phone at 613-907-3700. Please note that you have the right to file a complaint to the Office of the Privacy Commissioner of Canada regarding our handling of your personal information. For more information, please visit the Office of the Privacy Commissioner’s website at www.priv.gc.ca or contact the Office by phone at 1-800-282-1376.

T01 Provincial Enforcement Service (2023/11)