ARCHIVED - Lands and Economic Development Programs - Project Status Report

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Form Instructions

DCI# 472939.GCIMS (2015-2016)

Privacy Act Statement

This statement explains the purposes and use of your personal information. Only information needed to respond to program requirements will be requested. Collection and use of personal information is in accordance with the Privacy Act. In some cases, information may be disclosed without your consent pursuant to subsection 8(2) of the Privacy Act. The collection and use of your personal information for this Project Status Report is authorized under sections 18(2), 20, 24, 53, 58(1b), 58(1c), 58(3) and 60 of the Indian Act, 1985 R.S.C. I-5 , in conjunction with AANDC's responsibilities pursuant to s.67 of the Canadian Environmental Assessment Act, 2012 (CEAA 2012) and is required for your participation in AANDC lands, environment and economic development programs. The Organization Contact Information submitted is used for communication purposes of the proposed project/activity and will not be disclosed without your prior consent except as set out under section 8(2) of the Privacy Act. All other information in the form, including any annexes and appendices, may be shared directly with other AANDC systems, without any further consent and with other government departments, agencies and private sector organizations, as described in the following Personal Information Banks, as found in AANDC's Info Source and TBS developed standard Personal Information Bank:

  • Automated Document, Records, and Information Management Systems TBS PSU 904
  • Indian Lands Registry, AANDC PPU 090
  • Monitoring and Compliance of Reserve Land Instruments, AANDC PPU 096
  • Lands and Economic Development Services AANDC LED 1402
The personal information collected under AANDC PPU 90 is retained indefinitely by the Department. Information collected under AANDC PU 096 is retained for 5 years after the leases expire and is then transferred to Library and Archives Canada (LAC) as archival records. The Privacy Act states that you have a right of access to your personal information and may request changes to incorrect information. Contact your appropriate Aboriginal Affairs and Northern Development office to request access to your personal information, notify us about incorrect information or withdraw participation after submitting your information. For more information about your right of access. If you require clarification about this Statement or your right of access, contact our Privacy Coordinator by telephone at (819) 997-8277 or by email at the following address ATIP-AIPRP@aadnc-aandc.gc.ca. For more information on privacy issues and the Privacy Act in general, consult the Privacy Commissioner at the following address or by telephone at 1(800) 282-1376.

Recipient Name

Agreement Number

Project Name

Report Date (YYYYMMDD)

From

To

Project Status:

Transaction Activity Number (as identified in "Payment Plan" Annex)

Program (Indicate Program from which funding was received):

AANDC Amount Approved

AANDC Amount Received

Funding Expended to Date

Surplus/Deficit

If the supported project included environmental mitigation measures, as outlined in the terms of reference and/or funding agreement, did these measures have the desired effect/impact?

Provide a narrative report which describes the following:

Provide a statement of revenues and expenditures on key activities described in the project.

Attachment(s): Indicate the name(s) of supporting document(s) being submitted and the method of submission.

Name of Supporting Document

Method of Submission

The information provided is accurate to the best of my knowledge.

Given Name

Family Name

Title

Signature
X

Date (YYYYMMDD)

Date modified: