Members of Parliament and MP Constituency office – Consent Form

The Parole Board of Canada (PBC) will not disclose personal information to a Member of Parliament (MP) or an employee of an MP’s Office relating to a constituent’s pardon or record suspension or expungement or clemency application unless the constituent provides consent for this in writing. 

Members of Parliament and their constituency offices wishing to contact the PBC on behalf of a constituent should fax their request, along with signed consent from the individual concerned, to 613-941-4981 on official MP letterhead.

This form, once completed, represents consent on the individual’s part for the PBC to disclose personal information about his/her pardon or record suspension or expungement or clemency application to the identified MP and/or employee(s) of the MP’s Office. This consent is strictly limited to the disclosure of this information between the PBC and the MP/MP’s Office that is necessary to provide the supplementary information being requested. 

This consent can be withdrawn at any time. To be valid, the withdrawal must be submitted in writing to the Parole Board of Canada.

Note: Do not include the applicant's Social Insurance Number (SIN) in the consent form, the PBC does not require this information.

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