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Voluntary Consent to

Search and/or Seizure

Date of Search and/or Seizure / Location Search and/or Seizure is to Take Place
Pursuant to Section 8 of The Canadian Charter of Rights and Freedoms,
Part I of the Constitution Act, 1982, being Schedule B to the Canada Act 1982 (U.K.), 1982, c. 11:

Everyone has the right to be secure against unreasonable search or seizure.

The purpose of this section is to protect individuals from unjustified state intrusions upon their privacy.
In order to search an individual’s person, premises, or private dwelling place, the search must be authorized either through the individual’s consent or by a search warrant. An individual can refuse or revoke consent at any time.

I, , having been informed of my constitutional right as shown above, authorize , a Safety Codes Officer in the fire discipline acting on behalf of the , or his designate(s) to conduct a complete search of my premises at the address shown above.

I am aware that the search is being conducted to determine the cause and origin of the fire, explosion or other incident so as to protect life and property from further damage, and to fulfill the obligation under section 8(2) of the Administrative Items Regulation, Alta. Reg. 16/2004 with amendments up to and including Alta.Reg. 52/2011, which reads:

“A safety codes officer in the fire discipline shall investigate the cause and origin and circumstances of every fire within his jurisdiction in which a person loses his life or suffers injury requiring medical attention or in which property is damaged or destroyed.”

I allow the above named Safety Codes Officer or their designate to take and use photographs, video tape recordings, gas monitoring readings, digital images or any other means to record the scene.

I authorize and permit the above named Safety Codes Officer or their designate to remove from my premises or private dwelling any item, object, or physical substance for the purpose related to the safety and protection of persons or property, or in determining the cause and origin of this fire, explosion or other incident.

I am aware that in the event the investigation becomes a criminal matter, all material, documentation, and exhibits may be turned over to the appropriate police agency with jurisdiction.

I am aware that the above named Safety Codes Officer or their designate will be on the premises for a period of time. I have no objection to their entering and remaining on the premises or private dwelling until completion of their physical examination, which will not exceed days.

This written consent is being given voluntarily and without threats or promises of any kind. I realize that I may revoke this consent at any time.

I acknowledge that I can refuse to give consent to a search and/or seizure and that I am waiving that right by signing this consent form.

Signature of Person Consenting to Search/Seizure / Signature of Witness
Print Name / Print Name
Mailing Address Street / Signature of Witness

City/Town/Village Province Postal Code

/ Print Name

This personal information is being collected under the authority of the Safety Codes Act and will be managed in compliance with the Freedom of Information and Protection of Privacy Act.

MAFP 1338 (2004/12)