Government of Canada / Gouvernement du Canada

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Application for Copyright Clearance of Government of Canada Works

From Financial Consumer Agency of Canada

* indicates mandatory field.

1. APPLICANT INFORMATION

Complete Name

Organization Name

Type of Organization

Postal Address

City/Town

Province/State

Postal/Zip Code

Country

Telephone Number

Facsimile

E-Mail Address

Web Site Address

If permission is granted, person/organization in whose name permission is to be issued Individual named above
Organization named above
Other (specified below)

4. ADDITIONAL INFORMATION

Applicant Reference Number (If you wish to assign one)

I would appreciate a response by

Have you previously received approval to use the same material(s)? Yes
No

If yes, previous Crown Copyright File No

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Date modified:: 2019-03-01