Power of Attorney - Ministère de l`Éducation et de l`Enseignement

Power of Attorney
9020
This form must be completed by individuals who wish to authorize a third party to act on their behalf when dealing
with the Direction de la gestion des prêts of Aide financière aux études.
Please submit this fully-executed form by uploading it right into your online file using the Submit a document tab.
To learn how, see the Submit a document section of our Web site (www.afe.gouv.qc.ca).
Section 1 – Applicant’s Personal Information
Last name
Permanent code assigned by the Ministère
First name
Number
Apartment
Direction
Street
(North, South, East, West)
Municipality
Province
Municipality (cont.)
Postal code
Country
E-mail address
Section 2 – Authorization
I hereby authorize the Service de la gestion des programmes et des comptes, the Service des réclamations or the Service du recouvrement to provide
with any information in my file and, if applicable, to work out the repayment
Name of the authorized person
terms and conditions of my student loan with this person.
Date
Y
M
D
Applicant’s signature X
Section 3 – Signature
I certify that all the information provided is accurate and complete.
Date
Y
M
D
Applicant’s signature X
Ministère de l’Éducation et de l’Enseignement supérieur
Aide financière aux études
1035, rue De La Chevrotière
Québec (Québec) G1R 5A5
22-1652-16A (rev.16-03)