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1. Account Holder Information: Complete identification details of the account holder(s) including full legal name, address, contact information, and any account holder identification numbers
2. Bank Account Details: Specific information about the bank account(s) covered by this authorization, including account numbers, branch information, and type of accounts
3. Authorization Scope: Clear description of what information is authorized to be released and for what purpose
4. Recipient Information: Details of the person, institution, or entity authorized to receive the banking information
5. Duration of Authorization: Specific timeframe for which the authorization is valid, including start and end dates if applicable
6. Privacy Notice: Statement regarding how the information will be used and protected, in compliance with PIPEDA
7. Declaration and Signature: Formal declaration of authorization and space for account holder signature(s), date, and witness if required
1. Joint Account Holder Authorization: Additional section for joint account holders' information and authorization, required when the account has multiple owners
2. Specific Restrictions: Section detailing any limitations or restrictions on the information that can be released, used when the account holder wants to place specific constraints
3. Third Party Authorization: Required when someone other than the account holder is authorized to request or receive the information
4. Digital Consent Confirmation: Additional section for electronic submission cases, including verification methods and digital signature requirements
5. Language Selection: Required in regions where bilingual documentation is mandatory (e.g., Quebec)
1. Schedule A - Types of Information Authorized: Detailed checklist or list of specific types of banking information authorized for release (e.g., account balances, transaction history, loan information)
2. Schedule B - Authorized Recipients List: Used when multiple recipients are authorized to receive information, listing all authorized parties and their contact details
3. Appendix 1 - Identity Verification Requirements: List of acceptable identification documents and verification procedures for both the account holder and recipients
4. Appendix 2 - Privacy Policy Summary: Summary of relevant privacy policies and procedures for handling sensitive banking information
Account Holder
Authorized Period
Authorized Recipient
Banking Information
Bank Records
Confidential Information
Consent
Duration
Electronic Record
Financial Institution
Joint Account
Personal Information
Primary Account Holder
Privacy Laws
Regulated Institution
Release Authorization
Revocation
Secondary Account Holder
Sensitive Information
Third Party
Transaction History
Authorized Representative
Banking Relationship
Disclosure Period
Consent
Privacy
Information Scope
Duration
Revocation Rights
Confidentiality
Data Protection
Third Party Access
Identity Verification
Limitation of Liability
Indemnification
Governing Law
Account Details
Information Use
Security Measures
Representations and Warranties
Electronic Communications
Amendment
Termination
Banking & Financial Services
Real Estate
Insurance
Accounting & Tax
Legal Services
Investment & Securities
Mortgage Services
Government & Public Sector
Corporate Services
Credit Services
Legal
Compliance
Privacy Office
Customer Service
Operations
Risk Management
Treasury
Credit Administration
Document Management
Client Relations
Bank Manager
Compliance Officer
Privacy Officer
Financial Advisor
Mortgage Specialist
Credit Analyst
Legal Counsel
Account Manager
Financial Controller
Auditor
Risk Manager
Banking Operations Manager
Customer Service Representative
Treasury Manager
Relationship Manager
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