Registration Request for Surviving Spousal or Common-Law Partners Priority Entitlement

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For the use of the Public Service Commission (PSC) for employees of the public service to whom the retrospective provision applies; if used by other departments or agencies, remove the PSC address on the second page.

This form collects the information needed to register applicants who meet the requirements specified in subsections 8.1(2) or 8.1(3) of the Public Service Employment Regulations and are therefore entitled to be appointed to any position in the public service in an advertised external appointment process for which the Commission is satisfied that the spouse or common-law partner meets the essential qualifications.

1. BASIC INFORMATION ABOUT THE PERSON APPLYING FOR PRIORITY STATUS:

FAMILY NAME, given name:
Home address:
Work address:
Home telephone number:
Work telephone number:
E-mail address:
Fax number:

2. SUMMARY OF DOCUMENTS REQUIRED:

Please attach the following:

• Copy of the letter from the appropriate federally or provincially legislated plan certifying that the surviving spouse or common-law partner has qualified for compensation as a result of the death of the person that is attributable to the performance of duties, including the date of the death;
• Copy of the Applicant's résumé; and
• Copy of the Privacy Consent Form, duly signed.

3. CERTIFICATION/SIGNATURE by the Applicant:

The undersigned certifies that the information provided herein and/or attached is correct and complete, and that he/she:

• Is not a person already employed in the public service for an indeterminate period of time at the time this request is made; and
• Is the surviving spouse or common-law partner who has qualified for compensation as a result of the death of the person that is attributable to the performance of duties.

SIGNATURE:
Applicant:
Name:
Signature:
Date:

4. ADMINISTRATIVE CONTACT FOR QUESTIONS ABOUT THIS REQUEST:

If you need to discuss any aspect of this submission, contact the PSC’s Priority Administration Group at 613-995-3608 or by fax at 613-992-0407. For further information about the priority for surviving spouses or common-law partners and its administration in general, refer to the Priority Administration page of the PSC Web site at http://www.psc-cfp.gc.ca/prad-adpr/index-eng.htm

MAIL THIS APPLICATION TO:
Director General
Staffing and Assessment Services Branch
National Client Services Directorate
Public Service Commission
Room A2113
L'Esplanade Laurier, West Tower
300 Laurier Avenue West
Ottawa, Ontario
K1A 0M7