Form IV "Declaration, Undertaking and Acknowledgement (Limited Disclosure)" - Canada

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FORM IV
SUBJECT MATTER:
File No.:
DECLARATION, UNDERTAKING AND ACKNOWLEDGEMENT
LIMITED DISCLOSURE
WHEREAS, _____________________________________________ (name of party consenting to
limited disclosure), has filed with the Canadian International Trade Tribunal (the Tribunal) certain
confidential information and has consented to limited disclosure of this confidential information under
certain terms and conditions.
DECLARATION
I hereby declare that I am ordinarily resident in Canada.
UNDERTAKING
I hereby undertake:
(a) to use the information disclosed to me under the conditions of this undertaking exclusively for
the purpose of the subject proceeding;
(b) not to divulge any information disclosed to me under the conditions of this undertaking to any
person connected to the named client, customer or account, or to any other person without the
written authorization of the Tribunal, for any purpose;
(c) not to reproduce, in any manner, information disclosed under the conditions of this undertaking
without prior written approval by the Tribunal, with the exception of documents that are printed
directly from any electronic media issued by the Tribunal under the condition that they be
remitted to counsel in accordance with clause (f) below;
(d) not to copy to a computer, storage device or shared repository any information disclosed under
the conditions of this undertaking and contained on any electronic media issued by the
Tribunal, without prior written approval by the Tribunal;
(e) to keep confidential and to protect the information disclosed to me under the conditions of this
undertaking in the following manner, namely:
(1) except in the context of a hearing before the Tribunal, I will keep the following in my office
or under my control, at all times:
the complete set of documents provided to me under the conditions of this undertaking;
the complete set of documents that I have printed from any electronic media provided
to me under the conditions of this undertaking; and
FORM IV
SUBJECT MATTER:
File No.:
DECLARATION, UNDERTAKING AND ACKNOWLEDGEMENT
LIMITED DISCLOSURE
WHEREAS, _____________________________________________ (name of party consenting to
limited disclosure), has filed with the Canadian International Trade Tribunal (the Tribunal) certain
confidential information and has consented to limited disclosure of this confidential information under
certain terms and conditions.
DECLARATION
I hereby declare that I am ordinarily resident in Canada.
UNDERTAKING
I hereby undertake:
(a) to use the information disclosed to me under the conditions of this undertaking exclusively for
the purpose of the subject proceeding;
(b) not to divulge any information disclosed to me under the conditions of this undertaking to any
person connected to the named client, customer or account, or to any other person without the
written authorization of the Tribunal, for any purpose;
(c) not to reproduce, in any manner, information disclosed under the conditions of this undertaking
without prior written approval by the Tribunal, with the exception of documents that are printed
directly from any electronic media issued by the Tribunal under the condition that they be
remitted to counsel in accordance with clause (f) below;
(d) not to copy to a computer, storage device or shared repository any information disclosed under
the conditions of this undertaking and contained on any electronic media issued by the
Tribunal, without prior written approval by the Tribunal;
(e) to keep confidential and to protect the information disclosed to me under the conditions of this
undertaking in the following manner, namely:
(1) except in the context of a hearing before the Tribunal, I will keep the following in my office
or under my control, at all times:
the complete set of documents provided to me under the conditions of this undertaking;
the complete set of documents that I have printed from any electronic media provided
to me under the conditions of this undertaking; and
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any electronic media device provided to me under the conditions of this undertaking;
(2) I will store in a locked vault, safe or other secure storage device all documents and
electronic media provided to me and containing information disclosed to me under the
conditions of this undertaking when these documents and/or electronic media are not being
used; and
(3) where I am provided with electronic media issued by the Tribunal, I will not divulge any
access passwords;
(f) to remit to counsel representing me, _____________________________________________,
(insert name of counsel/person providing limited disclosure) all paper copy materials containing
information disclosed under the conditions of this undertaking, at the end of my participation in
the proceeding;
(g) to remove from any server or database all documents containing information disclosed under
the conditions of this undertaking, including notes, charts and memoranda based on such
information;
(h) to report promptly to the Tribunal any violation of this undertaking; and
(i) to inform the Tribunal immediately of any changes in the facts referred to in this undertaking.
ACKNOWLEDGEMENT
I hereby acknowledge that disclosure by me of any of the confidential information to which I have
been given access could result in economic harm to _________________________________________
(name of party consenting to limited disclosure).
Dated at ___________________ this _____ day of ___________________ 20___.
Signature:
Name (Print):
Company Name:
Address:
Telephone:
Fax:
E-mail:
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