Declaration of consent ME-0032-2309

Permanent immigration of a minor child accompanied by only one parent September 2023

General information

Who must fill out this declaration?

Except for the situations provided below, the parent or the person holding parental authority who does not accompany their child or children
minor child(ren), that is to say aged under 18 years, in their permanent immigration project to Quebec must necessarily
give your consent by filling out this form, signing it, and dating it.

Procedure to follow

The consent declaration must be authenticated by a person authorized for this purpose, for example: a lawyer, a notary,
a commissioner for oaths, a magistrate, a judge, a female or male justice officer, an employee of a ministry
or a governmental body or a diplomatic or consular representative of the country or territory of citizenship of the parent
who does not accompany.

The original version of this form must be accompanied by a photocopy of an identity document of the parent or the entitled person.
of parental authority that does not support.

The main applicant is not required to provide this form if they provide one of the following documents:
A photocopy of a judgment from a legally constituted court with jurisdiction in the matter, declaring the forfeiture.
of the parental authority of the parent or the person holding parental authority who is not accompanying;
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• A medical certificate or a judgment from a legally constituted court with jurisdiction in the matter, stating that the parent
or the person holding parental authority who does not accompany is not able to consent;
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A photocopy of a death certificate or document of the parent or the person holding parental authority who is not accompanying.

In any other circumstance where the parent or the person holding parental authority who is not accompanying is not able to
To provide consent, the main applicant must submit a supporting document with evidence.
documents will be analyzed by the Ministry.

Translation

If you submit documents or parts of documents in a language other than French or English, you must provide:
The document in the original language;
•The complete translation made by a recognized translator. To understand the requirements related to translations
And for the definition of recognized translator, visit our website at [Link]
formats.

If the original document is written in French or English but has a seal in another language, you
You must absolutely have this seal translated.

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Ministry of Immigration, Francization and Integration ME-0032-2309 (2023-09)
 Click here for the procedure

Declaration of consent ME-0032-2309

Permanent immigration of a minor child accompanied by only one parent September 2023

1. Information about your identity

Sex Feminine Masculine

Please specify your name(s)
and first name(s) in characters Maiden name First name(s)
printing as they appear
in your identity document.
Last name after marriage (if applicable) Other names or first names

Validity period:
Noof passport or other official identity document Start date (year/month/day) End date (year/month/day)

Citizenship Date of birth (year/month/day)

Place of birth

City Province or State Country or territory

Please provide the address

2. Home address
from the home where you
remain currently.
Number Street Apartment City

Province or State Postal code Country or territory

Home phone Phone at work Other phone

Email Other email

Indicate the address of 3. Correspondence address

correspondence if it is
different from your address
current and indicate the name Number Street Apartment City
of the person who resides there if
this address does not relate
not directly to you.
Province or State Postal code Country or territory

Name of the person Your link with this person Telephone

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Ministry of Immigration, Francization and Integration ME-0032-2309 (2023-09)
 4. Protection of personal information

Use of personal information provided

The personal information collected in this form is necessary for processing the selection request.
affiliated permanent. It is possible that we use this personal information for study, research purposes,
for the production of statistics as well as for program evaluation or service quality.

Protection of personal information

The personal information provided will be treated confidentially. It will only be consulted by authorized individuals.
employees of the Ministry of Immigration, Francisation and Integration (Ministry) who are qualified to receive them,
when they are necessary for the exercise of their functions.
Note that certain risks, rules, guarantees, and rights are associated with the processing of personal information and that we
we put everything in place to ensure their protection. They will be kept in accordance with our schedule
of conservation.

Consequences of your refusal to respond to the request

If you refuse to comply with this mandatory request for the collection and use of personal information,
This could impact the processing of the related permanent resident application.

Your rights regarding your personal information

You have the right to be informed of the personal information we hold about you and to have it communicated to you.
and to request its correction.
If you are in the territory of the European Union, you have the right to object to the processing of your information.
staff or request the restriction of processing. To exercise these rights, you must contact the person
in charge of document access and personal information protection within the Ministry. To know
how to do it, visit our website at the following address:Invalid input. Please provide text for translation instead of a URL.
access information.
If you believe that the use of your personal information is not in compliance with theLaw on access to documents of
public organizations and on the protection of personal datayou can file a complaint with the Access Commission
to the information of Quebec.

Consent to the collection and use of personal information

The consent you give in this form is valid until the objectives of the collection are met.

I have read this section on the protection of personal information and I consent to the collection
and to the use of the personal information provided.

Help to understand the scope of consent

For assistance in understanding the scope of this consent, you can contact
by phone with the Customer Contact Center at514 864-9191from the Montreal area or from outside Quebec
and at1 877 864-9191by the way in Quebec (at no charge).

Communication of personal information

The personal information provided in the application may be communicated to a public agency of Quebec.
from Canada and abroad, an educational institution, an employer, a financial institution, an organization
specialized in checking people's backgrounds in order to assess and verify the truth of the facts contained in
your statements.

I have read this section on the communication of my personal information and I understand.
the terms associated with it.

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Ministry of Immigration, Francisation and Integration ME-0032-2309 (2023-09)
 5. Declaration

I, the undersigned,

,
First name and last name of the parent or the person holding parental authority who is not accompanying.

declares being informed of the permanent immigration project to Quebec of

,
First name and last name of the accompanying parent

and I expressly authorize my child(ren):

born on:
First name and last name of the child Date of birth (year/month/day)

born on:
First and last name of the child Date of birth (year/month/day)

born on:
First name and last name of the child Date of birth (year/month/day)

to immigrate permanently to Quebec with this parent, even if I do not accompany them. I understand that in
by agreeing to this, I may be permanently separated from my aforementioned child(ren). I acknowledge
also that if I ever wanted to visit him or them, I would then have to meet the regulatory requirements
in effect.

In witness whereof, I have signed at

City Country or territory Date (year/month/day)

Signature of the parent or the person holding parental authority who is not accompanying:

6. Authorized person
Please indicate the last name
and the first name of the person Last name and first name Profession practiced
authorized to authenticate
this document, in character
of printing. Number Street Apartment City

Province or State Postal code Country or territory

Phone Email

Signature Professional seal of the authorized person

Translation of the seal

Signed at the
City Date (year/month/day)

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Ministry of Immigration, Francisation and Integration Print Delete ME-0032-2309 (2023-09)