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Access to Information and Privacy

Access to Information Request Form
(TBC/CTC 350-57)
Title Access to Information Request Form
Number (TBC/CTC 350-57)
Category Access to Information and Privacy

Which government institution holds my information?

It is important to first determine which government institution is most likely to have the information you are seeking.

Make an online request

Use the ATIP Online Request Portal, for a faster, easier and more convenient way to submit access to information or privacy requests. Apply online today to certain government institutions to save time and postage.

Mail a request

If you are unable to use the ATIP Online Request Portal, you may request information using the Access to Information Request Form (TBC/CTC 350-57) (available in PDF or HTML formats), or send a letter clearly explaining what records you are seeking, to the ATIP Coordinator of the government institution holding the information.

Available formats


Personal Information Request Form
(TBC/CTC 350-58)
Title Personal Information Request Form
Number (TBC/CTC 350-58)
Category Access to Information and Privacy

Which government institution holds my information?

It is important to first determine which government institution is most likely to have the information you are seeking.

Make an online request

Use the ATIP Online Request Portal, for a faster, easier and more convenient way to submit access to information or privacy requests. Apply online today to certain government institutions to save time and postage.

Mail a request

If you are unable to use the ATIP Online Request Portal, you may request information using the Access to Information Request Form (TBC/CTC 350-57) (available in PDF or HTML formats), or send a letter clearly explaining what records you are seeking, to the ATIP Coordinator of the government institution holding the information.

Available formats


Consent for a Personal Information Request Form
(TBC/CTC 350-60E)
Title Consent for a Personal Information Request Form
Number (TBC/CTC 350-60E)
Category Access to Information and Privacy

Available formats


Authorizing a Personal Information Request to be Made on Your Behalf Form
(TBC/CTC 350-55E)
Title Authorizing a Personal Information Request to be Made on Your Behalf Form
Number (TBC/CTC 350-55E)
Category Access to Information and Privacy

Available formats


Access to Information Tracking Document
(TBC/CTC 350-59)
Title Access to Information Tracking Document
Number (TBC/CTC 350-59)
Category Access to Information and Privacy

Available formats


Record Correction Request Form
(TBS/SCT 350-11)
Title Record Correction Request Form
Number (TBS/SCT 350-11)
Category Access to Information and Privacy

Available formats


Report on the Access to Information Act
(TBS/SCT 350-62)
Title Form for the Statistical Report on the Access to Information Act
Number (TBS/SCT 350-62)
Category Access to Information and Privacy

Instructions

Institutions must submit statistical reports annually to the Information and Privacy Policy Division on activities relating to the administration of the Access to Information Act that take place in their institutions.

Reports submitted must be created in XML or XLS formats; however an HTML version is available here to illustrate the data elements that are required in the report.

Statistical data for previous years are available in an open format.

Available formats


Report on the Privacy Act
(TBS/SCT 350-63)
Title Form for the Statistical Report on the Privacy Act
Number (TBS/SCT 350-63)
Category Access to Information and Privacy

Instructions

Institutions must submit statistical reports annually to the Information and Privacy Policy Division on activities relating to the administration of the Privacy Act that take place in their institutions.

Reports submitted must be created in XML or XLS formats; however an HTML version is available here to illustrate the data elements that are required in the report.

Statistical data for previous years are available in an open format.

Available formats


Phoenix pay system

Claim expenses, financial losses and damages caused by Phoenix

Disability Insurance

Disability insurance claim forms

The Disability Insurance Plan claim forms can be found on the Sun Life DI webpage: www.sunlife.ca/DI.

  • Employee’s Statement (490L-M-12500-E)
  • Attending Physician’s Questionnaire (490L-P-12500-GEN-E, 490L-P-12500-MHC-E, or 490L-P-12500-MSK-E)
  • Employer’s Statement (Immediate Supervisor or Manager)(4841-E)
  • Employer’s Statement (Compensation Advisor)(4811-E)

Leave

Application for Leave with Income Averaging
(TBS/SCT 325-10)
Title Application for Leave with Income Averaging
Number (TBS/SCT 325-10)
Category Leave

Available formats


Application for Pre-retirement Transition Leave
(TBS/SCT 325-9)
Title Application for Pre-retirement Transition Leave
Number (TBS/SCT 325-9)
Category Leave

Available formats


Dental Care

Employee claim forms for dental care
Pensioners’ claim forms for dental care
Pensioners’ Dental Services Plan Authorization for Claims Submission and Re-direction of Payment Form
(00093-E-3-05)
Title Pensioners’ Dental Services Plan - Authorization for Claims Submission and Re-direction of Payment
Number (Inventory Number 00093-E-3-05)
Category Pensioners’ Dental Services Plan

Available formats

Public Service Health Care Plan

Employee claim forms for the Public Service Health Care Plan

Public Service Management Insurance Plan

Claim Forms for Long-Term Disability

Forms to be completed and sent to iA Financial Group

  • Employee’s Statement (F54-1011A-57)
  • Attending Physician’s Questionnaire (F54-1014A-57 for a mental health condition), or (F54-1015A-57 for a musculoskeletal condition), or (F54-1016A-57 for all other medical conditions)
  • Employer’s Statement (F54-1012A-57 immediate supervisor or manager)
  • Employer’s Statement (F54-1013A-57 departmental compensation/Human Resources advisor)
Claim Form for Accidental Dismemberment Benefit
(TBS/SCT 5954, 5955)
Title Claim for Accidental Dismemberment Benefit
Number (TBS/SCT 5954, 5955)
Category Public Service Management Insurance Plan

Available formats


Claim Form for Death Benefit
(TBS/SCT 5948, 5949)
Title Claim for Death Benefit
Number (TBS/SCT 5948, 5949)
Category Public Service Management Insurance Plan

Available formats


Security

Security in Contracting

Security Requirements Check List (SRCL)
(TBS/SCT 350-103)
Title Security Requirements Check List (SRCL)
Number (TBS/SCT 350-103)
Category Security in Contracting

Requirement for completion

In accordance with Section 10.4 of the Security Policy for the Government of Canada, contracting authorities must:

  1. Ensure security screening of private sector organizations and individuals who have access to protected and classified information and assets, as specified in the standards.
  2. Ensure safeguarding of government assets, including IT systems.
  3. Specify the necessary security requirements in terms and conditions in any contractual documentation.

Available formats


Security Screening

Security Screening Certificate and Briefing Form
(TBS/SCT 330-47)
Title Security Screening Certificate and Briefing Form
Number (TBS/SCT 330-47)
Category Security Screening

Requirement for completion

In accordance with the Security Policy for the Government of Canada, both the requirement for and the processing of a personnel security screening action must be based on a specified need. As such, please do not initiate the completion of this or any other security screening form unless this need has been identified by the federal government department/agency that requested you to complete them.

For security reasons and to ensure that your own privacy rights are being safeguarded, security forms available on our Treasury Board Secretariat web-site cannot be electronically sent. As such, please print and mail or hand carry completed forms to the federal government department/agency that requested you complete them.

Available formats


Personnel Screening, Consent and Authorization Form
(TBS/SCT 330-23e) Archived

Archived information

Archived information is provided for reference, research or recordkeeping purposes. It is not subject à to the Government of Canada Web Standards and has not been altered or updated since it was archived. Please contact us to request a format other than those available.

Title Personnel Security Screening Form
Number (TBS/SCT 330-23)
Category Security Screening

Instructions prior to completing the form

In accordance with the Policy on Government Security, both the requirement for and the processing of a personnel security screening action must be based on a specified need. As such, please do not initiate the completion of this or any other security screening form unless this need has been identified by the federal government department/agency that requested you to complete them.

For security reasons and to ensure that your own privacy rights are being safeguarded, this security form cannot be sent electronically. It must be printed and mailed or submitted by hand directly to the federal government department/agency that requested you complete it.

Please pay special attention to obtain both the information required and carefully read the instructions provided. If necessary, please contact your Human Resources contact or security office for specifics.

Available formats


Security Clearance Form
(TBS/SCT 330-60e) Archived

Archived information

Archived information is provided for reference, research or recordkeeping purposes. It is not subject à to the Government of Canada Web Standards and has not been altered or updated since it was archived. Please contact us to request a format other than those available.

Title Security Clearance Form
Number (TBS/SCT 330-60)
Category Security Screening

Instructions prior to completing the form

In accordance with the Security Policy for the Government of Canada, both the requirement for and the processing of a personnel security screening action must be based on a specified need. As such, please do not initiate the completion of this or any other security screening form unless this need has been identified by the federal government department/agency that requested you to complete them.

For security reasons and to ensure that your own privacy rights are being safeguarded, security forms available on our Treasury Board Secretariat web-site can not be electronically sent. As such, please print and mail or hand carry completed forms to the federal government department/agency that requested you complete them.

Available formats


TB Submission

Treasury Board Submission
(TBC 300-1)
Title Treasury Board Submission Form
Number (TBC 300-1)
Category TB Submission

Instructions

These forms are being offered to you as an on-line service and are available to you in Rich Text (RTF) formats.

If you choose the RTF format, you will have two options for completing the form:

  1. Fill in the form on-screen and then print it for submission by mail;
  2. or print the form and fill in the fields by hand for submission by mail.

Available formats


Specimen Signature
(GC 136)
Title Specimen Signature
Number (GC 136)
Category TB Submission

Available formats


Labour Relations

Bargaining Agent Identification - Notice of Change
(TBS/SCT 340-51)
Title Bargaining Agent Identification Notice of Change
Number (TBS/SCT 340-51)
Category Labour Relations

Instructions

Fill-in by computer and send to the appropriate bargaining agent(s):

E-mail addresses for Bargaining Agents
Bargaining Agent E-Mail Address
Association of Canadian Financial Officers (ACFO) information@acfo-acaf.com
Association of Justice Counsel (AJC) admin@ajc-ajj.ca
Canadian Association of Professional Employees (CAPE) finance@acep-cape.ca
Unifor CATCA Local 5454 catca@catca.ca
Unifor Local 2182 president@2182.ca
Canadian Federal Pilots Association (CFPA) office.manager@cfpa-apfc.ca
Canadian Military Colleges Faculty Association (CMCFA) execasst@cmcfa-apcmc.ca
Canadian Merchant Service Guild (CMSG) CMSG@Ottawa-email.com
Canadian Union of Public Employees 104 (CUPE) secretary@cupe104.ca
Federal Government Dockyard Chargehands Association (FGDCA) FGDCA@Hushmail.com
Federal Government Dockyard Trades and Labour Council East (FGDTLC(E)) councileast@gmail.com
Federal Government Dockyard Trades and Labour Council West (FGDTLC(W)) councilwest@shaw.ca
International Brotherhood of Electrical Workers (IBEW) Paul.cameron@ibew2228.ca
Professional Association of Foreign Service Officers (PAFSO) finance@pafso-apase.com
Professional Institute of the Public Service of Canada (PIPSC) TB340_51@pipsc.ca
Public Service Alliance of Canada (PSAC) TBS-SCT340-51@psac-afpc.com
National Police Federation (NPF) darmstrong@npf-fpn.com or bsauve@npf-fpn.com
Union of Canadian Correctional Officers – CSN (UCCO-SACC-CSN) erika.yelle@csn.qc.ca

Available formats


Employee Consent to Provide Personal Information to Bargaining Agents
(TBS/SCT 340-51a) Archived

Archived information

Archived information is provided for reference, research or recordkeeping purposes. It is not subject à to the Government of Canada Web Standards and has not been altered or updated since it was archived. Please contact us to request a format other than those available.

Title Employee Consent to Provide Personal Information to Bargaining Agents
Number (TBS/SCT 340-51a)
Category Labour Relations

Available formats


Grievance Transmittal Form
(TBS/SCT 340-54)
Title Grievance Transmittal Form
Number (TBS/SCT 340-54)
Category Labour Relations

Available formats


Managerial or Confidential Position
(TBS/SCT 340-10)
Title Managerial or Confidential Position
Number (TBS/SCT 340-10)
Category Labour Relations

Available formats


Group Grievance Presentation (PSLRA s. 215)
(TBS/SCT 340-56)
Title Group Grievance Presentation (PSLRA s. 215)
Number (TBS/SCT 340-56)
Category Labour Relations

Available formats


Individual Grievance Presentation (PSLRA s. 208)
(TBS/SCT 340-55)
Title Individual Grievance Presentation (FPSLRA s. 208 or s. 238.24)
Number (TBS/SCT 340-55)
Category Labour Relations

Available formats


Policy Grievance Presentation (PSLRA s. 220)
(TBS/SCT 340-53)
Title Policy Grievance Presentation (PSLRA s. 220)
Number (TBS/SCT 340-53)
Category Labour Relations

Available formats


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