ARCHIVED - Personal Information Collection Statement
This information has been archived because it is outdated and no longer relevant.
Archived Content
Information identified as archived on the Web is for reference, research or recordkeeping purposes. It has not been altered or updated after the date of archiving. Web pages that are archived on the Web are not subject to the Government of Canada Web Standards. As per the Communications Policy of the Government of Canada, you can request alternate formats by contacting us.
Table of Contents
1.0 Example A: Mandatory provision of information, for example, for application for government benefits
Provision of the personal information requested on this form/Web page is mandatory, as required by [insert the section number of the applicable Act]. We will use your personal information for the following purpose(s):
- [Reason X]
- [Reason Y]
The personal information collected on this form/Web page is described in Personal Information Bank [name/number and link to the applicable Personal Information Bank description in InfoSource], and will be retained for [length of time].
Your personal information is protected under the federal Privacy Act, which states that you have the right to access your personal information and request changes to incorrect information. If you wish to avail yourself of this right or require clarification about this Statement, contact our Privacy Coordinator by email at [Privacy Coordinator email] or by calling [Privacy Coordinator phone number] or writing to [Privacy Coordinator mailing address]. For more information on privacy issues and the Privacy Act in general, consult the Office of the Privacy Commissioner Web site or call 1-800-282-1376.
If after reading this statement, you prefer to submit your application off the Internet, use one of the following methods:
- By Telephone: [telephone number]
- By Mail: [mailing address]
- In Person at: [building address]
- Teletypewriter: [teletypewrite number]
2.0 Example B: Optional provision of information, for example, a feedback form
Provision of the information requested on this form is voluntary. We will use your personal information for the following purpose(s):
- The information is being collected to provide additional information requested by you and assists us in improving our Internet suite of products and services.
The information collected on this form/Web page is described in Personal Information Bank [name/number and link to the applicable Personal Information Bank description in InfoSource], and will be retained for [length of time].
Your personal information is protected under the federal Privacy Act, which states that you have the right to access your personal information and request changes to incorrect information. If you wish to avail yourself of this right or require clarification about this Statement, contact our Privacy Coordinator by email at [Privacy Coordinator email] or by calling [Privacy Coordinator phone number] or writing to [Privacy Coordinator mailing address]. For more information on privacy issues and the Privacy Act in general, consult the Office of the Privacy Commissioner Web site or call 1-800-282-1376.
Where applicable: The transmission of this optional information is not secure and so sensitive personal information, for example, your Social Insurance Number, should not be included in your message.
If after reading this statement, you prefer to submit your comments off the Internet, use one of the following methods:
- By Telephone: [telephone number]
- By Mail: [mailing address]
- In Person at: [building address]
- Teletypewriter: [teletypewrite number]