Request for Permission - Municipal Candidacy Form

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Seeking Nomination or Being a Candidate in a Municipal Election – Important Information

• 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 municipal election, before or during the election period, you must request and obtain the permission of the Public Service Commission (PSC). You can only make public your intention to undertake activities in support of your nomination or candidacy after the PSC has granted you permission.
• This request is to be completed by the employee, the immediate supervisor and an Executive. The Executive's input must be provided by an EX (minimum EX-1). For organizations that do not have an EX group classification, the Executive should be from the group recognized as an equivalent. In consultation with your organization's Designated Political Activities Representative (DPAR), the PSC may seek additional information from senior officials in your organization, including the Deputy Head.
• Please consult your DPAR to find out about your organization's administrative procedures with respect to requesting permission to be a candidate in an election, including obtaining Executive and Deputy Head sign-off.
• 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:

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 leave of absence without pay. 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 publication.

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

• Municipality
• Province or territory
• Title of elected office sought
• Date of election
• Deadline to register as a candidate

The PSC may make permission conditional on you taking a LWOP before the date of the election. In addition, the PSC may require you to take a LWOP or cease to be an employee if you are elected.

• Elected office
  • Full-time
  • Part-time
• Number of hours per month you plan on committing to the elected office
• Date by which the PSC's decision is required

Please describe what activities you intend to undertake in support of your nomination and/or candidacy before the election date. For each activity, please indicate the frequency, expected duration and if it is being conducted during or outside working hours.

Provide the contact information of a municipal official who can provide information about the municipality and the election.

• Name
• Position title
• Telephone no.
• Fax no.
• E-mail address

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 municipal office or sitting as an elected official 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 municipality 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 municipality in which you are seeking to be elected?

9. Do you have direct interaction with residents, businesses, associations or groups from the municipality 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:

1. before and during the election period?
2. if you withdraw as a candidate or you are not elected and continue to work in your current position?
3. if you are 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 21 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. 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 continues to work in their current position?

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 is elected and continues to work in their current position?

20. Do you foresee any impact on your operations or the employee's work, given the time commitment required by this elected office?

21. 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 – Employee's Declaration

I understand and accept that should the PSC grant me permission to seek nomination or be a candidate in a municipal election, before or during the election period, or if elected, I must adhere to the following conditions:

• Campaigning must not be carried out during working hours unless an applicable leave of absence has been granted;
• Any leave before or during the election period, or if elected, is subject to the applicable articles of my collective agreement and the terms and conditions of employment, including operational requirements, and must be approved by my manager, subject to operational considerations;
• As an employee, it is understood that I will be conscious of the need to be perceived as politically impartial and should avoid participating in activities that could compromise this perception;
• If, at any point before or during the election period, the extent of my political activities changes, I must inform the PSC;
• I must inform the PSC of any changes to my duties, either as a federal employee and/or, if elected, as a municipal official, in order to allow the PSC to assess the impact, real or perceived, of such changes on my ability to perform my duties in a politically impartial manner, in accordance with subsection 113(1) of the PSEA;
• If I am elected, I must recuse myself from any council discussion, work or vote involving my federal organization, for the duration of my term;
• I must adhere to the Values and Ethics Code for the Public Sector and my organization's code of conduct.

The PSC reserves the right to reconsider the permission and/or conditions in light of any changes in my circumstances or as a result of an investigation made pursuant to section 118 of the PSEA.

Furthermore, I understand that upon review of my request, the PSC may impose additional conditions that I must accept in order for permission to be granted.

• Employee's signature
• Date

Part D – Statements

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

Employee

I have responded to the questions in this Request for Permission 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.

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

Immediate Supervisor

I have responded to the questions in this Request for Permission 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.

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

Executive Input

• Executive's name (please print)
• Position title
• Group and level
• Office address (including postal code)
• Telephone no.
• Facsimile no.
• E-mail address

On behalf of my organization, I am satisfied, to the best of my knowledge, that this employee's ability to perform their public service duties in a politically impartial manner will not be impaired, or be perceived as being impaired, by seeking nomination or being a candidate before and during the election period, and if elected.

• I concur
• I do not concur
  (please explain if there are any political impartiality or operational concerns regarding this employee's request)
  • Explanation
• Signature
• Date

Part E – Deputy Head Input (if required)

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.

• Deputy Head name (please print)
• Signature
• Date