Consent Form for Information Sharing This consent form authorizes the Fair Registration Practices Office (FRPO) to share information related to your request for review of a regulatory body's registration decision for the purposes of assessment and resolution, in compliance with privacy legislation.Personal Details:(Required) First Last Contact Email:(Required) Contact Phone:(Required)Compliance ConcernsRegulatory Body:(Required) Details of Request:(Required)Consent - Collection, Use and Disclosure of Personal Information:(Required) I agree to the consent statement.Information is being collected under the authority of section 61(c) of the Access to Information and Protection of Privacy Act, 2015, for compliance purposes. This project/program involves the review of compliance in accordance with the Fair Registration Practices Act and Regulations. The personal information collected may be exchanged and released to other relevant department(s), as well as regulatory bodies for the sole purpose of compliance with the Fair Registration Practices Act. If you have any questions about how this information will be collected, used and disclosed, please contact ATIPP-JGRD@gov.nl.ca. I acknowledge that I have read and understand the above information regarding the Collection, Use, and Disclosure of my personal information as outlined above.SignatureTo sign your name, use your finger, mouse or other compatible input device inside the dotted box. To start signing, press or click, hold and move. To stop signing, lift or release. To clear the signature, press or click the arrows icon in the bottom right corner.Date(Required) Month Day Year
