Request for Permission and Leave of Absence without Pay - Federal, Provincial and Territorial Form

Seeking Nomination or Being a Candidate in a Federal, Provincial and Territorial Election – Important Information

PDF Format (571 Kb)

• The Public Service Employment Act (PSEA) states that you may engage in any political activity as long as it does not impair, or is not perceived as impairing, your ability to perform your duties in a politically impartial manner.
• Prior to seeking nomination or being a candidate in a federal, provincial or territorial election, before or during the election period, you must request and obtain the permission of the Public Service Commission (PSC). You must also request and obtain from the PSC a leave of absence without pay (LWOP) to be a candidate during the election period. You can only make public your intention to undertake activities in support of your nomination or candidacy after the PSC has granted you permission.
• You must also request and obtain in advance from the PSC a LWOP before the election period in order to participate in political activities that will raise your visibility, which may impair, or be perceived as impairing, your ability to perform your duties in a politically impartial manner.
• If elected, you cease to be an employee of the public service.
• Provincial and territorial candidacy requests are to be completed by the employee, the immediate supervisor and an Assistant Deputy Minister (ADM) or the Deputy Head (DH). For organizations without ADMs, the input should be from the level recognized as an equivalent.
• Federal candidacy requests are to be completed by the employee, the immediate supervisor and DH.
• Please consult your organization's Designated Political Activities Representative (DPAR) to find out about your organization's administrative procedures with respect to requesting permission to be a candidate in an election, including obtaining ADM or DH input for provincial and territorial candidacy requests and DH input for federal candidacy requests.
• Each completed Request for Permission must be accompanied by an approved work description and organizational chart.
• If you are currently performing the duties of another position (such as acting, secondment or assignment), you must provide a separate Request for Permission and its attachments for both your substantive and assigned positions.
• You must submit a new Request for Permission each time you intend to seek nomination or be a candidate in an election, even if the PSC has previously granted you permission.
• The PSC will render a decision in writing within 30 days of receiving all the requested information, including your completed Request for Permission form and the approved work description and organizational chart. If you do not provide complete information, you may face the risk of a delay in obtaining a decision or the PSC may be unable to render a decision.
• For more information, please refer to the PSC Political Activities Web site.
• Each completed Request for Permission, along with its attachments, must be sent by mail, e-mail or fax to both persons indicated below:

Part A – Employee and Election Information

(This section is to be completed by the employee.)

• Last name
• Given name(s)
• Home address (including postal code)
  • Telephone no.
  • Facsimile no.
  • E-mail address
• Office address (including postal code)
  • Telephone no.
  • Facsimile no.
  • E-mail address
• In which official language do you prefer to receive your correspondence?
  • English
  • French
• Organization
• Branch, Directorate, Section
• Position title
• Group and level
• Position duration
  • Indeterminate
    • Full-time
    • Part-time
      • Number of hours per week
  • Term
    • From
    • To
  • Acting
    • From
    • To
  • Assignment/ Secondment
    • From
    • To
  • Seasonal
    • From
    • To
  • Immediate supervisor's name
    • Position title
    • Group and level
    • Office address (including postal code)
    • Telephone no.
    • Facsimile no.
    • E-mail address

Election Information

• Federal
• Provincial
• Territorial
• Electoral district
• Province or territory
• Title of elected office sought
• Date of nomination meeting
• Deadline to file nomination
• Deadline to withdraw nomination
• Date of election (if known)
• Date by which the PSC's decision is required

Planned Activities

In this section, please provide a list of activities you intend to undertake in support of your candidacy. Examples of activities could include, but are not limited to:

• Commenting publicly on decisions, actions, inactions, policies, programs and services of the Government of Canada;
• Holding press conferences;
• Having any type of communication with the media;
• Making editorial comments, regardless of the medium;
• Delivering public speeches, regardless of the forum;
• Maintaining and updating Web sites or blogs, or having them maintained and updated on your behalf;
• Selling party membership cards;
• Promoting in any way your political intentions in public.

Please indicate the date, frequency and expected duration of each activity during the following periods:

1. Prior to the nomination meeting
2. Prior to the election period

How did you become aware of your legal obligation to request and obtain PSC permission to seek nomination or be a candidate in this election (e.g. newspapers, poster, information session, brochure, e-mail, PSC Web site, DPAR, supervisor)?

Part B – Nature of the Duties and Visibility of the Position

(This section is to be completed by the employee and the immediate supervisor.)

This section provides information on possible concerns regarding the real or perceived impairment to the employee's ability to perform their duties in a politically impartial manner. In reviewing and analyzing the request, the PSC will consider factors such as the nature of the election, the employee's duties in the organizational context and the level and visibility of the employee's position, together with the heightened visibility that running for federal, provincial or territorial office may entail.

Questions 1 to 12 are to be completed by the employee.

The following questions pertain to your public service duties. Please answer these questions from the perspective of your role as a public servant. Where applicable, provide detailed information on the nature, scope and frequency of your duties.

1. Do you deal with elected officials, whether at the federal, provincial, territorial or municipal level, from the electoral district in which you are seeking to be elected?
2. Do you supervise staff, have delegated staffing authority and/or have influence in the hiring process?
3. Do you have financial authority (i.e. delegated signing authority pursuant to the Financial Administration Act)?
4. Do you have the power to enforce laws by seizing goods or detaining and arresting people?
5. Do you have regulatory enforcement responsibilities?
6. Do you review, recommend, approve or monitor contracts for goods and services, subsidies, grants or contributions?
7. Do you have direct interaction with your minister, other ministers or their staff?
8. Do you have direct access to information or do you handle files pertaining to residents of the electoral district in which you are seeking to be elected?
9. Do you have direct interaction with residents, businesses, associations or groups from the electoral district in which you are seeking to be elected?
10. Do you have direct interaction with the media (e.g. newspapers, television)?
11. Given the nature of both your public service duties and the elected office you are seeking, what is the likelihood that others may perceive that you are unable to perform your public service duties in a politically impartial manner:
    • a) before and during the election period?
    • b) if you withdraw as a candidate or you are not elected and continue to work in your current position?
12. Please provide any additional comments that may be relevant to your seeking the elected office in question.

Questions 13 to 20 are to be completed by the immediate supervisor.

13. Do you concur with the responses to questions 1-12 provided by the employee? If no, please explain.
14. Over and above the text of the work description provided, please summarize in your own words the five to eight main activities for which the employee is responsible.
15. Please describe the type of persons with whom this employee would typically interact on a regular basis, both within the federal public service (internal contacts) and outside (external contacts).
16. With respect to the employee's duties, what is the scope and impact of their decision-making responsibility?
17. Are you satisfied that the employee's ability to perform their public service duties in a politically impartial manner will not be impaired, or be perceived as being impaired, while the employee seeks nomination or is a candidate?
18. Do you foresee any impact on your operations or the employee's work if this employee is required to be on LWOP before the election period?
19. Are you satisfied that the employee's ability to perform their public service duties in a politically impartial manner will not be impaired, or be perceived as being impaired, if the employee withdraws as a candidate or is not elected and returns to work in their current position?
20. Please provide any additional comments related to the employee's public service duties that may be relevant to their seeking the elected office in question (e.g. visibility, influence, discretionary power).

Part C – Statements

(This section is to be completed by the employee and the immediate supervisor.)

Employee

I have responded to the questions in this Request for Permission and LWOP to the best of my knowledge. I understand that I may be contacted by the PSC to provide further information or details to assist in reviewing and analyzing this Request for Permission and LWOP.

• Employee's name (please print)
• Signature
• Date

Immediate Supervisor

I have responded to the questions in this Request for Permission and LWOP to the best of my knowledge. I understand that I may be contacted by the PSC to provide further information or details to assist in reviewing and analyzing this Request for Permission and LWOP.

• Supervisor's name (please print)
• Signature
• Date

Part D – Senior Management Input

(This section is to be completed by an ADM or equivalent, or the DH.)

Political Impartiality

If this employee seeks nomination or is a candidate before or during the election period: are you satisfied that this employee's ability to perform public service duties in a politically impartial manner will not be impaired, or be perceived as being impaired? If you have any concerns, please specify any operational or other arrangements that could be made to address any issues.

If this employee runs as a candidate, then withdraws as a candidate or is not elected, and returns to work: are you satisfied that this employee's ability to perform public service duties in a politically impartial manner will not be impaired, or be perceived as being impaired? If you have concerns, please specify any operational or other arrangements that could be made to address any issues.

Operational Impacts

Please describe any operational impacts on your organization that are, or could be, anticipated if the employee seeks nomination or is a candidate.

Other Comments

Statement

On behalf of my organization, I am satisfied, to the best of my knowledge, that the information appearing on this form is correct. I understand that I may be contacted by the PSC to provide further information or details to assist in reviewing and analyzing this Request for Permission and LWOP.

• ADM or equivalent, or DH name (please print)
• Signature
• Date

Privacy Notice Statement

The PSC is committed to protecting the privacy rights of individuals, including safeguarding personal information. The information provided on this form will be used by the PSC to review your request for permission to seek nomination or be a candidate in an election and, if applicable, for a LWOP. The information is collected pursuant to the PSEA (Section 11 and Part 7) and the Political Activities Regulations. It may also be used for follow-up and investigations under Part 7 of the PSEA, as well as for statistical purposes. The information provided is protected under the Privacy Act and will be disclosed only in accordance with that Act. It is retained in Personal Information Bank no. PSC PCE 763 of the PSC. Under subsection 12(2) of the Privacy Act, you may request to have information about yourself corrected or annotated if you believe there is an error or omission therein. The recorded information will be retained for 15 years after the request was made, then retained indefinitely by Library and Archives Canada. For additional information, please consult the INFO SOURCE.