Ігор

My personal information may include my application form, supporting documents, my
fingerprints and photographs and other biometric information, as required by the Gov-
ernment of Canada. My personal information may also include information related to
application, identity, biographic and contact details, including electronic records or data
related to my application.

Under the contract between VFS Global and the Government of Canada, the CVAC must
respect the principles of personal information, confidentiality and protection as set out in
various laws of Canada. I understand that if I have concerns with the handling of my per-
sonal information by the CVAC, I have the right to file a complaint with the Office of Priva-
cy Commissioner for Canada, using the contact information the CVAC has provided to
me.

I understand that the CVAC will only collect, use, disclose and retain my personal informa-
tion as required in its contract with the Government of Canada and for the purposes of
providing administrative support services and biometric collection services for my applica-
tion to enter Canada, where applicable. The Government of Canada has prohibited the
CVAC from using or disclosing my personal information for any other purpose without the
consent of IRCC, and such disclosure will only occur when and to the extent required by
law.

NAME (printed):

ADDRESS:

TELEPHONE NUMBER:

EMAIL ADDRESS:

SIGNATURE:

DATE:

SIGNED AT: (city, country)
Consent for Indirect Submission and/or Collection (to be completed
ONLY if travel agent or person other than applicant themselves is submitting
and/or collecting the visa application and decision)

I give my consent to the Canada Visa Application Centre in Rome, Italy (City, Country)
to receive / give my documents from / to Canada VAC.

Name of Person to submit an application or collect the decision on my behalf:

ANDRIIANA OLEKSIIENKO, SVITLANA LABIAK

Relationship to Applicant: COURIER

Applicant Signature:

Date:

Declaration to be signed ONLY
by applicants assisted by the CVAC staff with electronic application form.

I received the assistance of the CVAC staff for data entry of my application informa-
tion. I provided all information and responses required for the application. I have read
the completed and printed application form and declare that the information provided
is true and that the documents I am submitting in support of my application are gen-
uine and have not been altered in any way.

Name:

Signature: Date:
 AUTHORIZATION LETTER

This is to certify that I authorize my rep-
resentative, whose signature is verified below, to submit and to collect the following pass-
port from/to the Canada Visa Application Centre in Rome (Via Gallarate, 12, 00182 Roma
RM, Italy) on my behalf:

Passport :

Name of the Representative: ANDRIIANA OLEKSIIENKO

Passport of the Representative: FZ421624

Contact Details of the Representative:

Date and Signature of the Representative authorized to collect:

Date:

Applicant Signature: