*** Transcriber's Note::Please set your voice synthesizer to read most punctuation. When you encounter the caret sign at the end of a line, please enter the applicable information, if necessary. *** Canada Revenue Agency Protected B when completed RC193 E (25) (Page 1 of 3) Service Feedback Use this form to provide feedback on your experience with the service that you received from the Canada Revenue Agency (CRA). Service feedback refers to the quality and timeliness of the CRA's service. For more information, go to canada.ca/cra-service-feedback. Select the type of feedback you want to provide: Compliment ^ Suggestion ^ Complaint ^ If you are sending a complaint, the CRA will respond to you. If you are sending a compliment or suggestion, do you want the CRA to respond to you? Yes or No ^ Do not use this area. Section 1 - Client identification First name ^ Last name ^ Business name (if applicable) ^ Mailing address (apartment number - street number, street name, Post Office box, Rural Route) ^ City ^ Province or territory (or country, if outside Canada) ^ Postal or ZIP code ^ Main telephone number (including area code) ^ Alternate telephone number (including area code) ^ Social insurance number (enter 9 digits) ^ Business number (enter 9 digits) ^ Program identifier (enter 2 digits) ^ Reference identifier (enter 4 digits) ^ Other account number ^ Section 2 - Authorized representative identification To be completed if you are an authorized representative submitting this form on someone else's behalf. First name ^ Last name ^ Business name (if applicable) ^ Business number (enter 9 digits) ^ Program identifier (enter 2 digits) ^ Reference identifier (enter 4 digits) ^ Mailing address (apartment number - street number, street name, Post Office box, Rural Route) ^ City ^ Province or territory (or country, if outside Canada) ^ Postal or ZIP code ^ Telephone number (including area code) ^ For information on how you can authorize a person to act on your behalf, go to canada.ca/taxes-representative-authorization. RC193 E (25) (Page 2 of 3) Section 3 - Service feedback Please provide the details of your compliment, suggestion, or complaint. If applicable, include the name(s) of any CRA employee(s), office location(s), and/or phone number(s) you interacted with, a summary of your interactions, and any actions taken to resolve the issue. Important: - Do not include personal information such as credit card numbers, bank account details, passwords, medical information, or any other sensitive data about yourself or others. - If additional information is needed, we will contact you. How your information will be handled: Any personal information provided in the open text field will be used exclusively for the purpose of addressing your feedback. It will be securely stored and managed in accordance with privacy and security regulations, including the Privacy Act and other applicable legislation, to ensure the protection of the personal information collected. Any personal information in the open text field that is not relevant to processing your feedback will be removed in accordance with established information management policies and retention guidelines. ^ RC193 E (25) (Page 3 of 3) Section 3 - Service feedback (continued) ^ Personal information is collected under the authority of section 220 of the Income Tax Act and section 275 of the Excise Tax Act and will be used solely for addressing and/or resolving service-related issues. The Social insurance number, Business number and Other account numbers are collected pursuant to sections 237 and 248 of the Income Tax Act and section 275 of the Excise Tax Act for identification purposes. Personal information, including feedback resolution, may be disclosed to you or to an individual you have designated as your authorized representative. When necessary to resolve feedback, personal information may be shared or verified with other federal, provincial, or territorial government institutions to the extent permitted by law. Failure to provide the requested personal information may result in the CRA being unable to process your request. For further information, refer to Personal Information Bank CRA PPU 571 (Service Feedback Program) at canada.ca/cra-info-source. Under the Privacy Act, individuals have a right of protection, access to and correction of their personal information, and to file a complaint with the Office of the Privacy Commissioner of Canada regarding the handling of their personal information. How to submit this form Online Use the "Submit documents" service at: - My Account at canada.ca/my-cra-account if you are an individual - My Business Account at canada.ca/my-cra-business-account if you are a business owner - Represent a Client at canada.ca/taxes-representatives if you are an authorized representative or employee Fax - 1-866-388-7371 from Canada or the United States - 1-819-536-0701 from outside Canada and the United States Mail CRA Service Feedback National Intake Centre 4695 Shawinigan-Sud Boulevard Shawinigan QC G9P 5H9 CANADA