Consent Form to Disclose Information to a Designated Individual

If you are enquiring on behalf of another person about the status of a government clearance or an immigration screening file, the request must be accompanied by the Consent Form to Disclose Information to a Designated Individual. See the printable version of the form at the bottom of this page.

If a request is incomplete a reply will not be issued by CSIS. Please allow up to eight weeks for the processing of requests. 

For security reasons and to ensure that your own privacy rights are being safeguarded, security forms available on the CSIS website cannot be sent electronically.  Please print and mail or fax the completed form to CSIS, to the attention of:

Assistant Director, Security Screening
Canadian Security Intelligence Service
P.O. Box 9732, Station “T”
Ottawa, Ontario
K1G 4G4
Fax: 613-231-0672

This document is available in Adobe Acrobat format. If you do not have an Adobe Acrobat Reader or are unfamiliar with Adobe Acrobat, refer to the alternative formats and plug-ins.

Printable PDF Form

(Print form, fill in by hand, sign, submit by mail or fax)

Note: Printable Version Available

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