Public Works and Government Services Canada
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Protected B when completed Personal information bank PWGSC PPU 045
ANY FALSE STATEMENT, MISREPRESENTATION OR CONCEALMENT OF ANY MATERIAL FACT ON THIS APPLICATION OR ANY DOCUMENT PRESENTED IN SUPPORT OF THIS APPLICATION MAY LEAD TO DENIAL, SUSPENSION OR REVOCATION OF REGISTRATION AND BE GROUNDS FOR CRIMINAL PROSECUTION.
READ INSTRUCTIONS CAREFULLY - Forms completed incorrectly will be returned to the addressee.
ALLOW 14 CALENDAR DAYS TO PROCESS.
A copy of a valid PASSPORT signature page and Export Permit (if applicable) must accompany the application.
A visitor is eligible to apply for exemption from registration only if a registered person submits an application
Attach a copy of a valid passport signature page
Expected duration, frequency and purpose of the visit(s)
2 - Expected Duration of Visit(s)
Provide the Export Control List group, item number and description of the controlled goods that the visitor will examine, possess or transfer.
Attach a copy of your Export Permit (if applicable)
The information requested below is specific to the Designated Official
I, the undersigned, certify the information contained in this application is true, complete and correct and the individual is a “Visitor” as per the definition in the Controlled Goods Regulations and as outlined on page 3 of the Guide.
Privacy Act Statement
The information you provide in this form is mandatory and collected under the authority of Defence Production Act on Controlled Goods for the purpose of services for security assessment. This information is used by Controlled Goods Directorate employees who need to know the information in order to respond to your request and/or the Controlled Goods Program requirements. We may share the personal information with the Canadian Security Intelligence Service. The information collected is described under the Personal Information Bank PWGSC PPU 045 which is detailed at www.infosource.gc.ca. The personal information will be kept as long as the registrant is active and will then be transferred to Library and Archives Canada. Individuals have the right to the protection of and access to their personal information under the Privacy Act (http://laws-lois.justice.gc.ca/eng/acts/P-21/).
“Visitor” means an individual who is not an officer, director or employee of a person registered under these Regulations and who is not:
This form may only be submitted by a Designated Official of the Registered Person/Company. The Designated Official will be advised of the approval or denial of the application.
Allow 14 CALENDAR DAYS to process once the application has been received.
Complete all sections. If an item is not applicable, indicate “N/A” in the space provided. If additional space is required, use an extra sheet of paper and attach to the application.
Read the instructions carefully. Completing the form incorrectly will result in processing delays.
Any changes to the application must be reported to the Controlled Goods Directorate immediately.
Please note that the certificate is not transferable.
If you require assistance, please contact the Call Centre at 1-866-368-4646. Please ensure to complete as much of the form as possible and have a list of questions ready for our Call Centre agent prior to contacting us.
The purpose of the visit must clearly indicate specific information related to a program, project or contract for which the visitor may be required to examine, possess or transfer controlled goods. Please indicate the expected duration of the visit.
Please note that exemption from registration is valid for the period noted on the Certificate of Exemption.
The description of controlled goods should provide sufficient detail so as to disclose the true identity of the goods. Avoid the use of trade names, generic names or general terms that do not adequately describe the goods.
Identify the Export Control List group and item number.
It is the responsibility of the Designated Official to ensure that the visitor meets the definition of a “visitor” as found in the Controlled Goods Regulations.
You must provide the following documentation:
Once the application is complete, please submit to the Controlled Goods Directorate via mail, e-mail or by facsimile to the following coordinates:
Mailing Address Controlled Goods Directorate Public Works and Government Services Canada 2745 Iris Street, 3rd Floor Ottawa ON K1A 0S5
Courier Address Controlled Goods Directorate 2745 Iris Street, 3rd Floor c/o PWGSC Central Mail Room Place du Portage, Phase III, 0B3 11 Laurier Street Gatineau QC K1A 0S5
The mailing address identified above should be used in its entirety in order to ensure receipt of documents at our location.
HOW TO CONTACT US
Telephone Toll-free 1 866-368-4646 National Capital Region (613) 948-4176
Facsimile (613) 948-1722
E-mail dmc-cgd@tpsgc-pwgsc.gc.ca
Web site http://ssi-iss.tpsgc-pwgsc.gc.ca/dmc-cgd/
Last updated: 2010-04-01
