E646: Customs self assessment
Importer application, Part 1

Protected B when completed

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 (1.2 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.


The Customs Self Assessment (CSA) program offers approved importers the benefits of:

Do you qualify for the CSA program?

You may qualify for the CSA program if you:

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.

  1. Part I: You will provide basic information about your business structure and activities. The CBSA will then conduct a risk assessment of your company.
  2. 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 to:

Canada Border Services Agency
Manager, CAS Application
1980 Matheson Blvd E
Mississauga ON  L4W 5R7

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.

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: Q N A
Business address
Province or State
Postal code or Zip code

2. Mailing address (if different from above)
Province or State
Postal code or Zip code

3. Client ownership type: corporation, sole proprietor, partnership, or other? (specify)

4. Include a chart of your corporate structure with this application.

5. Web site: Q N A

6. Dun and Bradstreet number: Q N A

7. Canadian Standard Industrial Code (SIC)

8. Briefly describe the company s key business activities and products. Provide a separate sheet if more space is required.

9. CSA contact name:
Last name
First name
Language of correspondence: English or French?
Email address
Telephone number
Fax number

Contact mailing address (if different from above):
Province or State
Postal code or Zip code

10. Approximately how many employees are there in your company in Canada?

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.

Business Number (BN) and RM account identifier: Provide 15 digit number

Business name

Business address
Province or State
Postal code or Zip code

Trading or operating name(s)

Web site: Q N A

Dun and Bradstreet number: Q N A

Canadian Standard Industrial Code (SIC): Q N A

Is the division responsible for its own procurements? Yes/No

Does the division import goods into Canada? Yes/No

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.

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 (for example, hiring policies, and reporting procedures for suspicious or criminal activities). Include copies of standard operating procedures or internal booklets if they are available. Please include the effective date of your documents and practices.

14. a) Do you use foreign trade zone(s) in the United States for goods that are imported into Canada? Yes/No

b) If yes, list the location of the foreign trade zone(s) and describe any process that takes place within the foreign trade zone (example, repacking, further manufacturing).


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. Yes/No

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.

Authorized person's name
Title or office

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

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 Monday to Friday (08:00 to 16:00 local time, except statutory holidays). TTY also available within Canada at 1-866-335-3237.

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