Authorize the Disclosure of Your Driving Record

Understanding the Authorization for the Disclosure of a Driving Record by the Société de l’assurance automobile du Québec – With Intermediary

If you are involved in activities that require sharing your driving history—such as applying for a job involving heavy vehicle operation, insurance purposes, or other legal needs—you may need to authorize the Société de l’assurance automobile du Québec (SAAQ) to disclose your driving record to a third party. The official form for this process is titled "Authorization for the Disclosure of a Driving Record by the Société de l’assurance automobile du Québec – With Intermediary," and it is designated with the code 5981A 35.

What is the purpose of this form?

This form allows a licensed driver to give explicit permission for the SAAQ to share their driving history with a designated intermediary. The information disclosed can include suspensions, revocations, demerit points, offences, and involvement in accidents while driving a heavy vehicle. The authorization ensures that the third party, such as a potential employer or insurance company, can verify the driver’s record in accordance with legal and administrative requirements.

Who should fill out this form?

The driver whose record is being disclosed must complete the section titled "Authorization of the Driver’s Licence Holder." This includes providing their driver’s license number, full name, date of birth, and signature. The intermediary organization or individual, who will receive the information, must also fill out their details in the "Intermediary" section, including their name, address, and contact information.

How to properly complete the form

Driver’s Information

• Driver’s license number: Enter your license number exactly as it appears on your card.
• Name and date of birth: Clearly write your full name and date of birth in the format Year-Month-Day.
• Signature: Sign the form to authorize the disclosure. Your signature confirms your consent for the SAAQ to release your driving record.

Intermediary Details

• Name and organization: Provide the full name of the person authorized to receive your record and their organization or company.
• Address and contact info: Complete the address, including street number, name, apartment number if applicable, province, postal code, and telephone number.
• Additional contact: If applicable, include work and home telephone numbers and extensions.

Important considerations when filling out the form

Ensure all information is printed clearly, preferably on-screen before printing to avoid errors. Handwritten entries should be legible, and modifications, crossings, or erasures are not permitted. The form must be completed in full, and it must be sent along with the corresponding Driving Record Search form (4941A) to the SAAQ.

Validity and limitations of the authorization

This authorization is valid for a period of 12 months from the date of signature. After this period, a new authorization must be completed if further disclosures are required. The form's purpose is strictly limited to transmitting the driver’s record to the designated intermediary, who agrees to use the information solely for this purpose.

Where and how to submit the form

The completed form, along with the Driving Record Search form, can be submitted via mail or through the SAAQ’s digital platforms, following their instructions. It is advisable to consult the SAAQ website or contact their customer service for specific submission procedures and applicable fees.

Additional tips and common errors

• Double-check all entries: Incorrect or incomplete information can delay processing.
• Signature: Ensure your signature matches the one on your driver’s license.
• Expiration date: Be aware that the authorization expires after 12 months, requiring renewal for ongoing needs.

Privacy and data protection

The SAAQ emphasizes that personal information collected through this process is handled confidentially, in accordance with applicable privacy legislation. The data may be shared with licensing agents and certain government agencies, including those outside Québec, for purposes such as statistical analysis, audits, or investigations. You have the right to access, correct, or request a copy of your personal information by contacting the SAAQ’s privacy office.