Guidelines for Use of the Lists of Electors

Annex C – Declaration Template for Lists Distributed to Candidates

Declaration Regarding the Use of the Lists of Electors

[Candidates]

I, [insert name of individual to whom lists are provided], do solemnly declare the following:

I have received a copy of the lists of electors for the electoral district of [insert name of electoral district].
I understand the importance of protecting the security and confidentiality of the personal information contained in the lists of electors.
I understand that I may use the lists of electors provided to [insert name of candidate] only during the electoral period for the purposes of campaigning and soliciting contributions as a candidate or on behalf of the candidate.
I will take appropriate measures to protect the confidentiality of the personal information contained in the lists. I will not disclose any information contained in the lists.
I will not keep a copy of the lists and will return my copy once I have completed the task for which it was provided to me.

Signature: ________________________________ [individual to whom lists are provided]

Signature of witness: _______________________ [person responsible for privacy safeguards]

This ______ [day] of __________________ [month], _______ [year].

Note: A copy of this declaration should be kept on file by the person designated by the candidate as responsible for privacy safeguards.