A link to the Portable Document Format (PDF) of this form is provided below. The content of the form is duplicated in HTML following the PDF link.
Protected A when completed
This form is to be completed by all newly appointed qualified officers, partners and directors. Please check the appropriate box.
- Qualified officer / Partner / Director
- Date of birth (YYYY-MM-DD)
- Are you a Canadian citizen and/or a permanent resident of Canada? (Yes/No)
- Home (principal) address
- Day telephone number
- Evening telephone number
- Name of brokerage firm
- Facsimile number
- E-mail address
- Please indicate below any customs broker examinations you have passed together with the appropriate date.
- Customs Brokers Professional Examination (YYYY-MM-DD)
- Customs Brokers Departmental Examination (prior to November 1986) (YYYY-MM-DD)
- Please indicate below your relevant employment history. The CBSA reserves the right to contact these employers for references. (To be completed only by the qualified officers.)
- Customs broker and location
- Date from (YYYY-MM-DD)
- Date to (YYYY-MM-DD)
The Customs Brokers Licensing Regulations require that individuals, qualified officers, partners and directors be of good character; and partnerships and corporations licensed to transact business as customs brokers, be of good character/reputation. Please complete the following:
- Have you ever been convicted of a criminal offence for which you have not received a pardon? (Yes/No) If "Yes," please provide details.
- Have you ever declared bankruptcy? (Yes/No) If "Yes," please provide details.
I declare that to the best of my knowledge, the information given in this application is true. I make this declaration knowing it is of the same importance as if made under oath and by virtue of the Canada Evidence Act. I hereby authorize the release, by the custodian thereof, of any information required by the Canada Border Services Agency that is necessary in the determination of my suitability to become a licensed customs broker.
Criteria to be met by individuals who intend to transact business as customs brokers and by directors of licensed corporations
The Customs Brokers Licensing Regulations require that any individual who transacts business as a customs broker and all directors of licensed corporations meet certain criteria.
Individuals who transact business as customs brokers must meet all the requirements of these Regulations and be approved by the Canada Border Services Agency (CBSA).
Professional status is required of an individual who intends to apply for a customs broker licence either on his or her own behalf (as a sole proprietor), on behalf of a partnership or on behalf of a corporation. Applicants applying for a licence on behalf of a corporation must also be appointed as an "officer" of that corporation. "Officers" of corporations must be appointed by the directors of a corporation.
In order to be approved by the CBSA an individual must meet the following:
- be a citizen or a permanent resident of Canada;
- be of good character;
- be at least 18 years old;
- have passed the Customs Brokers Professional Examination; and
- apply for a customs broker licence on his/her own behalf or be appointed as an officer of a corporate applicant.
Directors of a corporate applicant for a customs brokers licence must meet the following:
- be of good character; and
- be at least 18 years old.
The majority of the directors must be citizens or permanent residents of Canada.
Directors of a corporate applicant must be appointed by the shareholders.
Loss of Status
Professional status may be lost if the individual holding such status has a break in employment as a customs broker. Please consult the CBSA's Memorandum D1-8-1, Licensing of Customs Brokers, for details.
Individuals who lose their professional status because of such a lapse may regain it by passing the Customs Brokers Professional Examination.
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