iZEV Program consumer consent form

Please download and use PDF to complete the form

The federal Incentives for Zero-Emission Vehicles (iZEV) Program provides point-of-sale incentives on eligible zero-emission vehicles (ZEVs). To do this, participating dealerships agree to lower the purchase or lease price of eligible ZEVs and apply to the iZEV Program for a grant on behalf of the purchaser or lessee. In order to apply for this grant, dealerships are required to share the personal information of purchasers or lessees with Transport Canada to support the administration of the iZEV Program.


I, , hereby authorize [participating dealership name] to collect my personal information provided to the dealership and provide that information to His Majesty the King in Right of Canada as represented by the Minister of Transport (“Canada”). 

I further hereby consent and authorize Canada to:

  1. collect my personal information provided to the dealership;
  2. store the personal information as set out below;
  3. use the personal information provided to the participating dealership for the purposes of receiving the federal incentive under the iZEV Program and for the purposes outlined below; and
  4. validate personal information with the Canadian Council of Motor Transport Administrators for the purposes set out below.  

This information is collected by Canada for the purpose of:

  1. administering the iZEV Program, which includes but is not limited to determining the eligibility for a grant under the iZEV Program, evaluating the iZEV Program, and informing any of Canada's future program policies related to ZEVs; and
  2. validating eligible ZEV purchases, which includes the vehicle identification number, province, postal code (and date of birth for individuals) of the purchaser / lessee with the Canadian Council of Motor Transport Administrators.

By signing this form, I further give permission to be contacted by Canada or its representatives by phone, email, or other electronic means with respect to my experience with the iZEV Program and to inform future programs and policies related to zero-emission vehicles. Further to signing this form I acknowledge that I may withdraw my consent to such further contacts by providing the notice by sending an email to iZEV-iVZE@tc.gc.ca.

The personal information provided by the dealership as part of the grant application and related documents is collected for the iZEV Program in accordance with the Minister of Transport's mandate as described in section 5 of the Canada Transportation Act and by virtue of the powers available under section 20 of the Motor Vehicle Safety Act. All personal information provided to Transport Canada will be used and disclosed in accordance with the Privacy Act. The personal information collected is described in a Personal Information Bank entitled Incentives for Zero-Emission Vehicles Program (bank number TC PPU 052). Under the provisions of the Privacy Act, individuals have the right of access to, correction of and protection of their personal information. Instructions for obtaining personal information are provided in Info Source, a copy of which is available in major public and academic libraries or online at http://www.infosource.gc.ca. To report a privacy concern please visit https://www.priv.gc.ca/en/report-a-concern/file-a-formal-privacy-complaint/.

In consideration of the opportunity to participate in the iZEV Program, I hereby release His Majesty the King in Right of Canada, his agents, officers, employees, contractors, successors, and assigns from any claims, liability, damages, action or causes of action arising from or relating to the personal information disclosed and its use or retention. I am signing this iZEV Program Consumer Consent Form of my own free will and have a full understanding and comprehension of its terms. 

Printed Name of Eligible Vehicle Purchaser / Lessee

Date of Birth (year/month/day) – for individuals only



Business Number – for organizations only



Date (Year/Month/Day)