Form SC ISP-1603 "Consent to Communicate Information to an Authorized Person" - Canada

Form SC ISP-1603 is a Service Canada form also known as the "Form Sc Isp-1603 "consent To Communicate Information To An Authorized Person" - Canada". The latest edition of the form was released in November 12, 2013 and is available for digital filing.

Download an up-to-date Form SC ISP-1603 in PDF-format down below or look it up on the Service Canada Forms website.

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Download Form SC ISP-1603 "Consent to Communicate Information to an Authorized Person" - Canada

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Service
PROTECTED B (when completed)
Canada
Personal Information Bank
HRSDC PPU 031, 116, 140, 146, 175, 649
Consent to Communicate Information to an Authorized Person
This form allows you to name a person (such as your spouse, partner, other family member or friend) to communicate on
your behalf with Service Canada regarding your Canada Pension Plan (CPP) and Old Age Security (OAS) benefits. It
allows Service Canada to communicate to this authorized person your personal information concerning CPP/OAS
benefits, payments, income, contributions and changes to your address (excluding the address where your cheque is
mailed or the bank account where the payment is deposited). It does not provide authority for the person to apply for
benefits for you, change your payment address or request/change voluntary tax withhold. If our records indicate that a
legal representative, such as a Power of Attorney or Trustee, is authorized to act on your behalf, all communications will
be made through that legal representative.
Note: Third Parties are not currently authorized to use the CPP/OAS On-line Services.
Section 1 : Your Consent (you must complete and sign this section)
First Name
Initial
Family Name
Social Insurance Number
I hereby give my consent for Service Canada to communicate personal information on my behalf and to act on
information received from the authorized person, named in Section 2, concerning CPP/OAS benefits, payments,
income, contributions and changes to my address (excluding the address where my cheque is mailed or the bank
account where the payment is deposited) on the programs below:
Check applicable box(es):
Canada Pension Plan
Old Age Security
This consent form does not provide authority to the person to apply for benefits on my behalf or to change my
payment address (the address where my cheque is mailed or the bank account where the payment is deposited) or
request/change voluntary tax withhold. I understand that this consent remains valid unless I cancel it in writing and that
it is only valid if Service Canada receives this form within one year from the date I sign it. I also understand that this
consent is revoked in the event of my death.
Date:
Your Signature:
X
Year Month Day
Section 2 : The person you would like us to communicate with must complete and sign this section
Relationship to client:
First Name
Initial
Family Name
Telephone numbers: Home
Work
Other
Complete mailing
address:
(No., Street, Apt., P.O. Box, R.R.)
City
Province
Country
Postal Code
I understand that I can communicate with Service Canada on the program(s) checked off above to give and receive
personal information on behalf of the person named in Section 1. I also understand that I do not have the authority to
apply for a benefit or to change the payment address (the address where the cheque is mailed or the bank account
where the payment is deposited) or request/change voluntary tax withhold on this person's behalf.
Date:
Signature:
X
Year Month Day
Protection of your personal information
CPP and OAS cannot give your personal information to any person or organization without your written consent, except
where authorized by CPP or OAS legislation. You (or your authorized legal representative) have the right to request a
copy of the information in your file.
How to reach CPP and OAS:
In Canada and the United States, call
- English:
1-800-277-9914
- French:
1-800-277-9915
- TTY users:
1-800-255-4786
To learn more about this form, Canada Pension Plan, Old Age Security Program and Service Canada on-line services,
please visit our Internet site at: servicecanada.gc.ca
Service Canada delivers Human Resources and Skills Development Canada
programs and services for the Government of Canada.
Disponible en français
SC ISP-1603 (2013-11-12) E
1 of 2
Service
PROTECTED B (when completed)
Canada
Personal Information Bank
HRSDC PPU 031, 116, 140, 146, 175, 649
Consent to Communicate Information to an Authorized Person
This form allows you to name a person (such as your spouse, partner, other family member or friend) to communicate on
your behalf with Service Canada regarding your Canada Pension Plan (CPP) and Old Age Security (OAS) benefits. It
allows Service Canada to communicate to this authorized person your personal information concerning CPP/OAS
benefits, payments, income, contributions and changes to your address (excluding the address where your cheque is
mailed or the bank account where the payment is deposited). It does not provide authority for the person to apply for
benefits for you, change your payment address or request/change voluntary tax withhold. If our records indicate that a
legal representative, such as a Power of Attorney or Trustee, is authorized to act on your behalf, all communications will
be made through that legal representative.
Note: Third Parties are not currently authorized to use the CPP/OAS On-line Services.
Section 1 : Your Consent (you must complete and sign this section)
First Name
Initial
Family Name
Social Insurance Number
I hereby give my consent for Service Canada to communicate personal information on my behalf and to act on
information received from the authorized person, named in Section 2, concerning CPP/OAS benefits, payments,
income, contributions and changes to my address (excluding the address where my cheque is mailed or the bank
account where the payment is deposited) on the programs below:
Check applicable box(es):
Canada Pension Plan
Old Age Security
This consent form does not provide authority to the person to apply for benefits on my behalf or to change my
payment address (the address where my cheque is mailed or the bank account where the payment is deposited) or
request/change voluntary tax withhold. I understand that this consent remains valid unless I cancel it in writing and that
it is only valid if Service Canada receives this form within one year from the date I sign it. I also understand that this
consent is revoked in the event of my death.
Date:
Your Signature:
X
Year Month Day
Section 2 : The person you would like us to communicate with must complete and sign this section
Relationship to client:
First Name
Initial
Family Name
Telephone numbers: Home
Work
Other
Complete mailing
address:
(No., Street, Apt., P.O. Box, R.R.)
City
Province
Country
Postal Code
I understand that I can communicate with Service Canada on the program(s) checked off above to give and receive
personal information on behalf of the person named in Section 1. I also understand that I do not have the authority to
apply for a benefit or to change the payment address (the address where the cheque is mailed or the bank account
where the payment is deposited) or request/change voluntary tax withhold on this person's behalf.
Date:
Signature:
X
Year Month Day
Protection of your personal information
CPP and OAS cannot give your personal information to any person or organization without your written consent, except
where authorized by CPP or OAS legislation. You (or your authorized legal representative) have the right to request a
copy of the information in your file.
How to reach CPP and OAS:
In Canada and the United States, call
- English:
1-800-277-9914
- French:
1-800-277-9915
- TTY users:
1-800-255-4786
To learn more about this form, Canada Pension Plan, Old Age Security Program and Service Canada on-line services,
please visit our Internet site at: servicecanada.gc.ca
Service Canada delivers Human Resources and Skills Development Canada
programs and services for the Government of Canada.
Disponible en français
SC ISP-1603 (2013-11-12) E
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Service
Canada
Consent to Communicate Information to an Authorized Person
Instruction Sheet
Why do I need to complete this form?
Personal information about you and the financial benefits paid to you is confidential. We need your
signed consent if you want Service Canada to communicate with another person (such as your
spouse, partner or accountant) for CPP/OAS program benefit matters. You can give this consent by
completing and signing Section 1 of the attached form. The person you would like us to
communicate with must complete and sign Section 2.
Your signed consent allows Service Canada to communicate confidential CPP/OAS program benefit
information to this person and allows him or her to communicate with us on your behalf. This
consent will stay in effect until a written cancellation request is received from you or in the event of
your death.
Note: Third Parties are not currently authorized to use the CPP/OAS On-line Services.
Does my spouse, common-law partner, or other family member need my consent?
Yes, Service Canada cannot communicate your personal benefit information with your spouse,
common-law partner, son or daughter without your signed consent.
What will this person be allowed to do on my behalf?
When you give signed consent to Service Canada to communicate with this person, you are letting
that person provide and receive your personal program benefit information such as benefit rates,
changes to your address excluding payment address (the address where your cheque is mailed or
the bank account where the payment is deposited), OAS income, Canadian residence information
and CPP contributions.
What is this person not allowed to do on my behalf?
This consent form does not provide authority to the person to apply for benefits, withdraw or
cancel benefits, change your payment address (the address where your cheque is mailed or the
bank account where the payment is deposited), request or change voluntary tax withhold.
Who can change my payment address including direct deposit information?
Generally, only you can ask us to change your payment address (the address where your cheque is
mailed or the bank account where the payment is deposited). However, a legal representative,
someone with a power of attorney granted from you, or a trustee, can ask us to change this
information. That person does not need to complete this form, but he or she has to provide a
certified copy of the legal document that names him or her as acting in that capacity.
SC ISP-1603 (2013-11-12) E
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Service
Canada
Service Canada Offices
Canada Pension Plan
Mail your forms to:
The nearest Service Canada office listed below.
From outside of Canada: The Service Canada office in the province where you last resided.
Need help completing the forms?
Canada or the United States: 1-800-277-9914
All other countries: 613-990-2244 (we accept collect calls)
TTY: 1-800-255-4786
Important: Please have your social insurance number ready when you call.
NEWFOUNDLAND AND LABRADOR
ONTARIO
Service Canada
For postal codes beginning with "K or P"
PO Box 9430 Station A
Service Canada
St. John's NL
A1A 2Y5
PO Box 2013 Station Main
CANADA
Timmins ON
P4N 8C8
CANADA
PRINCE EDWARD ISLAND
Service Canada
MANITOBA AND SASKATCHEWAN
PO Box 8000 Station Central
Service Canada
Charlottetown PE
C1A 8K1
PO Box 818 Station Main
CANADA
Winnipeg MB
R3C 2N4
CANADA
NOVA SCOTIA
Service Canada
ALBERTA / NORTHWEST TERRITORIES
PO Box 1687 Station Central
AND NUNAVUT
Halifax NS
B3J 3J4
Service Canada
CANADA
PO Box 2710 Station Main
Edmonton AB
T5J 2G4
CANADA
NEW BRUNSWICK AND QUEBEC
Service Canada
PO Box 250 Station A
BRITISH COLUMBIA AND YUKON
Fredericton NB
E3B 4Z6
Service Canada
CANADA
PO Box 1177 Station CSC
Victoria BC
V8W 2V2
CANADA
ONTARIO
For postal codes beginning with "L, M or N"
Service Canada
PO Box 5100 Station D
Scarborough ON
M1R 5C8
CANADA
Disponible en français
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