Fillable eFACILITY USER ACCESS FORM (Alberta Student Aid)

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eFACILITY USER ACCESS FORM (Alberta Student Aid)

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Country of origin: CANADA
File type: PDF

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VEHICLE INSPECTION PROGRAM
eFACILITY USER ACCESS FORM
FACILITY INFORMATION
Facility Number Facility Name
Facility Contact Name
Facility Contact Email
Phone Number
eFACILITY USER INFORMATION
Name Email Address
Number
Birthdate Action
Add
Remove
Add
Remove
Add
Remove
Add
Remove
Add
Remove
Add: Provide user eFacility access for facility listed Remove: Remove user’s eFacility access for facility listed
FACILITY CONTACT ACKNOWLEDGMENT
I confirm that I am the facility contact for the above noted inspection facility and am authorized to request and cancel
eFacility user access on behalf of the facility. I understand that as the facility contact, I am responsible for monitoring
inspections completed at our facility and within the eFacility system.
Name
Date
Signature
The information is being collected is for the purposes of motor vehicle administration in accordance with the Traffic Safety Act. The Freedom of
Information and Protection of Privacy Act, s. 33 (c) governs Alberta Transportation’s collection of this information. Please direct question about the
collection and use of this information to Vehicle Inspection Program, Alberta Transportation, Twin Atria Building, 4999 – 98 Avenue, Edmonton,
Alberta T6B 2X3, Phone: 780-427-8901.
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eFACILITY USER ACCESS FORM (Alberta Student Aid)

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Completed 20 April 2021

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