同意書

需要我們代表您向聯邦政府機構立案嗎？請填寫下方表單，授權我們代表您處理相關事宜！

請注意，若您需要移民事務方面的協助，我們在主選單中提供有專門的同意書連結。

本辦公室僅能為列治文中選區–馬寶（Richmond Centre–Marpole）的選民提供協助。為確保您是該選區的居民，請在此處驗證您的郵遞區號。

Full Name:

First Name*

Last Name*

Address:

Mailing Address*

City*

Postal Code*

Date of Birth:

Day

Month

Year

Contact Information:

E-mail

Phone*

Issue*

Comments

Consent:

I hereby request that the office of Chak Au, Member of Parliament, assist me with the issue stated above.

For this purpose I authorize the office of the Member of Parliament Chak Au and/or his representatives to consult the necessary government departments or agencies on my behalf and for the government department/agency to release any and all information in my file to the Member of Parliament and his staff. MP Au and his representatives may use and share with government officials any and all personal information and documentation, including correspondence, which I have provided to him or his representatives to the extent necessary in their efforts to assist me.

I agree