BSF728 - Electronic export reporting of controlled goods process

Privacy Statement - The information you provide in this document is collected under the authority of the Customs Act - Section 95 for the purposes of administering the Canada Border Services Agency (CBSA) Export Program. The information may be disclosed internally for purposes of Program verification and integrity.

Failure to provide the information requested on this form may result in being excluded from participating in the electronic process. Individuals have the right of access to and/or can make corrections of their personal information under the Privacy Act. The information collected is described within Info Source under the “Export Program” Personal Information Bank CBSA PPU 1103 which is detailed at http://www.cbsa-asfc.gc.ca.

• Canadian Head Office
  • Company Name
  • Address
  • City
  • Province/Territory
  • Postal Code
  • Business Number
• Contact Persons
  • Contact Person
  • E-mail address
  • Telephone
• Port of Exit
  • * Please, provide name of the port (s) of exit and CAED or the G7-EDI numerical identifier of the port (s) of exit.
• Terms of Agreement
  • The terms of agreement are:
    • Permits must be valid for at least 1 year.
    • Company must ensure permits are kept current.
    • The company must hold multiple permits with Department of Foreign Affairs, Trade and Development (DFATD).
    • The company must report export shipments electronically via the Canadian Automated Export Declaration (CAED) or G7 Electronic Data Interchange (G7-EDI). Ministère des Affaires étrangères, du Commerce et du Développement (MAECD).
    • As an authorized person, I _________________________________, fully agree to the terms of agreement stipulated above and certify that the information provided on this form and on any documents attached is, to the best of my knowledge, correct and complete.
    • Signature
    • Date

Date modified:

2014-01-17