Form E646 Part 1 "Customs Self Assessment - Importer Application" - Canada

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B
PROTECTED
when completed
This information is being collected according to the
provisions of the Access to Information Act. It is being
stored in the Accelerated Commercial Release
Operations Support System (ACROSS) under
Program Record Number RC CTA 125.
CUSTOMS SELF ASSESSMENT – IMPORTER APPLICATION – PART I
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.
PDF (1.5 Mb) [help with PDF
files]
This information is being collected according to the provisions of the Access to Information Act. It is being stored in the Accelerated
Commercial Release Operations Support System (ACROSS) under Program Record Number RC CTA 125.
Introduction
The Customs Self Assessment (CSA) program offers approved importers the benefits of:
• a streamlined accounting and payment process for all of their imported goods; and
• a streamlined clearance option for CSA eligible goods when an approved carrier and registered driver are involved.
Do you qualify for the CSA program?
You may qualify for the CSA program if you:
• have your head office in Canada or the United States or operate a branch office in Canada or the United States;
• have imported commercial goods into Canada at least once prior to the 90 days before the day on which the application was
received;
• are without contraband or major commercial infractions;
• are prepared to invest in your business systems; and,
• can provide senior management representation that your business processes and systems will support the CSA program
requirements.
How do you apply for the CSA program?
There are two parts to the CSA application process. You must receive approval from the CBSA for each part before moving on to
the next.
• Part I – You will provide basic information about your business structure and activities. The CBSA will then conduct a risk
assessment of your company.
• Part II – You will have to document your commercial processes and audit trails.
• You will be asked to sign a Summary of Program Requirements which outlines specific requirements, once the application is
approved.
To begin, an authorized officer of your company must complete the attached Part I application forms and send them to:
Canada Border Services Agency
Manager, CSA Application
1980 Matheson Blvd. E.
Mississauga ON L4W 5R7
CANADA
Do not proceed to Part II until you have received CBSA approval of your Part I application.
Note
The CBSA reserves the right to request additional information for the purposes of this application process.
Need more information?
If you would like more information about the CSA program, you can call the CBSA office nearest your head office. You can also visit
our Website.
(Cover)
(Ce formulaire existe aussi en français.)
E646 E (20)
Page 1 of 5
B
PROTECTED
when completed
This information is being collected according to the
provisions of the Access to Information Act. It is being
stored in the Accelerated Commercial Release
Operations Support System (ACROSS) under
Program Record Number RC CTA 125.
CUSTOMS SELF ASSESSMENT – IMPORTER APPLICATION – PART I
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.
PDF (1.5 Mb) [help with PDF
files]
This information is being collected according to the provisions of the Access to Information Act. It is being stored in the Accelerated
Commercial Release Operations Support System (ACROSS) under Program Record Number RC CTA 125.
Introduction
The Customs Self Assessment (CSA) program offers approved importers the benefits of:
• a streamlined accounting and payment process for all of their imported goods; and
• a streamlined clearance option for CSA eligible goods when an approved carrier and registered driver are involved.
Do you qualify for the CSA program?
You may qualify for the CSA program if you:
• have your head office in Canada or the United States or operate a branch office in Canada or the United States;
• have imported commercial goods into Canada at least once prior to the 90 days before the day on which the application was
received;
• are without contraband or major commercial infractions;
• are prepared to invest in your business systems; and,
• can provide senior management representation that your business processes and systems will support the CSA program
requirements.
How do you apply for the CSA program?
There are two parts to the CSA application process. You must receive approval from the CBSA for each part before moving on to
the next.
• Part I – You will provide basic information about your business structure and activities. The CBSA will then conduct a risk
assessment of your company.
• Part II – You will have to document your commercial processes and audit trails.
• You will be asked to sign a Summary of Program Requirements which outlines specific requirements, once the application is
approved.
To begin, an authorized officer of your company must complete the attached Part I application forms and send them to:
Canada Border Services Agency
Manager, CSA Application
1980 Matheson Blvd. E.
Mississauga ON L4W 5R7
CANADA
Do not proceed to Part II until you have received CBSA approval of your Part I application.
Note
The CBSA reserves the right to request additional information for the purposes of this application process.
Need more information?
If you would like more information about the CSA program, you can call the CBSA office nearest your head office. You can also visit
our Website.
(Cover)
(Ce formulaire existe aussi en français.)
E646 E (20)
Page 1 of 5
B
PROTECTED
when completed
CUSTOMS SELF ASSESSMENT - IMPORTER APPLICATION - PART I
Section A – Legal Entity Identification
1. Name of Legal Entity
Language of correspondence
English
French
Business Number (BN) (Provide 9-digit Registration Number)
Trading, operating, or partnership name
N/A
Business address
City
Province or State
Postal code or Zip code
Country
2. Mailing address (if different from above)
City
Province or State
Postal code or Zip code
Country
3. Client ownership type
corporation
sole proprietor
partnership
other (specify)
4. Include a chart of your corporate structure with this application.
5. Web site
N/A
6. Dun and Bradstreet number
7. Canadian Standard Industrial Code (SIC)
N/A
8. Briefly describe the company's key business activities and products (provide a separate sheet if more space is required).
9. CSA
Last name
First name
Language of correspondence
Contact name
English
French
Title
Email address
Telephone number
Fax number
Contact mailing address (if different from above)
City
Province or State
Postal code or Zip code
Country
10. Approximately how many employees are there in your company in Canada?
E646 E (20)
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Section B - Divisions
11. Identify all Canadian divisions of your company that import goods into Canada. If you need more space, please copy this page and attach copies to this application.
N/A
Business Number (BN) and RM account identifier (Provide 15 digit number)
Business name
Business address
City
Province or State
Postal code or Zip code
Country
Trading or operating name(s)
Web site
N/A
Dun and Bradstreet number
Canadian Standard Industrial Code (SIC)
N/A
Is the division responsible for its
Does the division import goods
Yes
No
Yes
No
own procurements?
into Canada?
Briefly describe the key business activities or business line, and products of this division.
12. If applicable, please list all other BN and RM account identifiers and names that you have not identified above.
N/A
Business Number (BN) and RM account identifier
Business name
Section C – Additional Applicant Information
13. Please describe any internal policies your company has in place to minimize the risk of criminal activities (e.g., hiring policies, and reporting procedures for suspicious orcriminal
activities). Include copies of standard operating procedures or internal booklets if they are available. Please include the effective date of your documents andpractices.
Page 3 of 5
Yes
No
14. a) Do you use foreign trade zone(s) in the United States for goods that are imported into Canada?
b) If yes, list the location of the foreign trade zone(s) and describe any process that takes place within the foreign trade zone (e.g., repacking, further manufacturing)
andorigin of those goods.
Location
Process
Origin
15. a) Does your company operate its own fleet for importing goods into Canada?
Yes
No
b) If yes, provide its carrier code(s).
16. a) Do you have any agreements or arrangements with other government departments or agencies for meeting
their release and clearance requirements?
Yes
No
b) If yes, please describe the arrangement for each government department or agency, as it may relate to
your imports under CSA clearance option. Provide a separate sheet if more space is required.
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Section D – Certification
Willfully failing to provide information or providing false information constitutes a violation of section 8 of the Customs Act. You must inform us of any change
to the information you enter on this form.
As an authorized officer of the applicant company, I certify that the information given on this form and any document attached is, to the best of my knowledge,
true, accurate, and complete.
Signature
Authorized person's name
Title or office
Date (YYYY/MM/DD)
Completing this application form does not constitute approval to act as a CSA importer. Only after you have successfully completed the two
steps of the application process will you be considered an approved CSA importer.
Do not make any CSA-specific investments to your business systems until the application process is complete.
Please forward the completed application, and a chart of your corporate structure to the CSA Application office listed below
CSA Application Office
Canada Border Services Agency
Manager, CSA Application
1980 Matheson Blvd. E.
Mississauga ON L4W 5R7
CANADA
General information
For general enquiries within Canada, call the Border Information Service at 1-800-461-9999. From outside Canada call 204-983-3500 or 506-636-5064 to
which long distance charges will apply. Agents are available Monday to Friday (08:00 - 16:00 local time/except statutory holidays). TTY is also available
within Canada at 1-866-335-3237.
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