Application for registration

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Internal use only

Any false statement, misrepresentation or concealment of any material fact on this application or any document presented in support of this application may lead to denial, suspension or revocation of registration and be grounds for criminal prosecution.

Read instructions carefully

Incomplete applications for registration will not be processed and will be returned to the sender.

Once fully completed application and supporting documentation have been received, allow 32 business days to process.

A. Preferred language of correspondence
B. Type of application

For new and renewal applications, complete all sections of the form.

For amendment applications, complete Sections A, B, C and H, as well as any other section where there are changes from the original application. not applicable "n/a".

In any instance where this form does not allow sufficient space for a complete answer, attach a separate page as required.

C. Business information

1. Type of business (attach evidence of the legal status of the business)
5. Address/number/email

D. Registration justification

Controlled Goods

10. Provide a description of the controlled goods the applicant intends to examine, possess or transfer (refer to the Controlled Goods List contained in the Schedule to the Defence Production Act (hereafter referred to as the CGL) in conjunction with the Guide to the New Schedule to the Defence Production ActFootnote 1 and provide the CGL entry or sub-entry)
Description of controlled goods CGL entry (including the most accurate sub-entry)  
a
b
c
d
e

Business contract/work obligations

12. Length of Contract
13. Contact person (reporting authority)

Other requirements

E. Business site - provide any business site address where controlled goods will be kept

Site (1) to be:
16. Site (1) Are controlled goods kept at this location?
17. Site (1)
Site (1) Description of controlled goods Site (1)CGL entry (including the most accurate sub-entry)
a
b
c
d
e
18. Site (1) Has a security plan been implemented for this business site?

If you answered no to question 18, be reminded that this is a condition of registration provided under section 10 (e) of the Controlled Goods Regulations that requires a registered person to establish and implement a security plan in respect of each place of business in Canada where controlled goods are kept. Failure to comply with this condition constitutes a serious breach of the regulations for which you could be charged under subsection 45(2) of the Defence Production Act and which may result in the suspension/revocation of your registration.

19. Site (1) Will records of transfers of controlled goods be kept at this location?
20. Site (1) Will records of employee security assessments be kept at this location?
23. Site (1) Designated official’s information
Designated official’s telephone number.

To add more business sites go to Schedule 1 attached.

F. Ownership information

Identify individual(s) and/or business(es) that own 20% or more of the voting shares, and indicate percentage of ownership. For business(es) identified, provide ownership information up to and including the ultimate owner in the corporate tree, and whether the organization is publicly traded, following the format below. Examples on how to complete this section are found in Section F of the instructions attached.

F1. Please indicate if your organization is publicly traded.
F 1 A. identify individual or business
F 1B. identify individual or business
F 1C. identify individual or business
F2. Please indicate if your organization is publicly traded.
F 2A. identify individual or business
F 2B. identify individual or business
F 2C. identify individual or business
F3. Please indicate if your organization is publicly traded.
F 3A. identify individual or business
F 3B. identify individual or business
F 3C. identify individual or business

G. Business officials

G. Business officials to be:
G - 1. identify each officer(s), director(s), partner(s), proprietor(s)
G - 2. identify each officer(s), director(s), partner(s), proprietor(s)
G - 3. identify each officer(s), director(s), partner(s), proprietor(s)

If more space is required go to Schedule 2 attached.

H. Certification and consent

(Only an individual identified in section G above may complete this section)

I, the undersigned, as the individual authorized by the applicant, do hereby certify that the information contained in this application is true, complete and correct. I acknowledge and agree to comply with the responsibilities outlined in the Defence Production Act and the Controlled Goods Regulations with respect to the examination, possession or transfer of controlled goods.

Consent for publication

In accordance with s.37 (2) of the Defense Production Act in order to assist all registered persons in exercising due diligence when transferring controlled goods to another person, the Controlled Goods Program makes publicly available on its website a list of all registered persons who have provided their consent to be listed

Consent to display information on the Controlled Goods Program website will result in details being available to the public online. Select one of the following options.
  • to have the organization's name, head office civic address and phone number posted on the Controlled Goods Directorate (CGD) Web site.

Signature of authorized individual ________________________________

Date (year-month-day) ________________________________

Print name ________________________________

Protection of information

Personal information provided on this application is protected and used in accordance with the provisions of the Privacy Act (Personal Information Bank Number PWGSC PPU 045). The information is collected under the authority of the Defence Production Act to determine the current and ongoing entitlement of your company to register with the Controlled Goods Program. The information may be verified.

Schedule 1

E. Business site (cont'd) Provide any business site address where controlled goods will be kept

Site (2)

Site (2) to be:
2. Site (2) Are controlled goods kept at this location?
3. Site (2)
Site (2) Description of controlled goods CGL entry (including the most accurate sub-entry)
a
b
c
d
e
4. Site (2) Has a security plan been implemented for this business site?

If you answered no to question 4, be reminded that this is a condition of registration provided under section 10 (e) of the Controlled Goods Regulations that requires a registered person to establish and implement a security plan in respect of each place of business in Canada where controlled goods are kept. Failure to comply with this condition constitutes a serious breach of the regulations for which you could be charged under subsection 45(2) of the Defence Production Act and which may result in the suspension/revocation of your registration.

5. Site (2) Will records of transfers of controlled goods be kept at this location?
6. Site (2) Will records of employee security assessments be kept at this location?
9. Site (2) Designated Official's Information

Site(3)

Site (3) to be:
2. Site (3) Are controlled goods kept at this location?
3. Site (3)
Site (3) Description of controlled goods CGL entry (including the most accurate sub-entry)
a
b
c
d
e
4. Site (3) Has a security plan been implemented for this business site?

If you answered no to question 4, be reminded that this is a condition of registration provided under section 10 (e) of the Controlled Goods Regulations that requires a registered person to establish and implement a security plan in respect of each place of business in Canada where controlled goods are kept. Failure to comply with this condition constitutes a serious breach of the regulations for which you could be charged under subsection 45(2) of the Defence Production Act and which may result in the suspension/revocation of your registration.

5. Site (3) Will records of transfers of controlled goods be kept at this location?
6. Site (3) Will records of employee security assessments be kept at this location?
9. Site (3) Designated official's Information

Site (4)

Site (4) to be:
2. Site (4) Are controlled goods kept at this location?
3. Site (4)
Site (4) Description of controlled goods CGL entry (including the most accurate sub-entry)
a
b
c
d
e
4. Site (4) Has a security plan been implemented for this business site?

If you answered no to question 4, be reminded that this is a condition of registration provided under section 10 (e) of the Controlled Goods Regulations that requires a registered person to establish and implement a security plan in respect of each place of business in Canada where controlled goods are kept. Failure to comply with this condition constitutes a serious breach of the regulations for which you could be charged under subsection 45(2) of the Defence Production Act and which may result in the suspension/revocation of your registration.

5. Site (4) Will records of transfers of controlled goods be kept at this location?
6. Site (4) Will records of employee security assessments be kept at this location?
9. Site (4) Designated official's Information

Site (5)

Site (5) to be:
2. Site (5) Are controlled goods kept at this location?
3. Site (5)
Site (5) Description of controlled goods CGL entry (including the most accurate sub-entry)
a
b
c
d
e
4. Site (5) Has a security plan been implemented for this business site?

If you answered no to question 4, be reminded that this is a condition of registration provided under section 10 (e) of the Controlled Goods Regulations that requires a registered person to establish and implement a security plan in respect of each place of business in Canada where controlled goods are kept. Failure to comply with this condition constitutes a serious breach of the regulations for which you could be charged under subsection 45(2) of the Defence Production Act and which may result in the suspension/revocation of your registration.

5. Site (5) Will records of transfers of controlled goods be kept at this location?
6. Site (5) Will records of employee security assessments be kept at this location?
9. Site (5) Designated official's Information

Schedule 2

G. Business officials (Cont'd)

to be:
G - 4. Business identify each officer(s), director(s), partner(s), proprietor(s)
G - 5. Business identify each officer(s), director(s), partner(s), proprietor(s)
G - 6. Business identify each officer(s), director(s), partner(s), proprietor(s)
G - 7. Business identify each officer(s), director(s), partner(s), proprietor(s)
G - 8. Business identify each officer(s), director(s), partner(s), proprietor(s)
G - 9. Business Identify each officer(s), director(s), partner(s), proprietor(s)
G - 10. Business Identify each officer(s), director(s), partner(s), proprietor(s)

Footnotes

Footnote 1

In the case of any discrepancy, the Controlled Goods List (CGL) to the Defence Production Act takes precedence over the Guide

Return to footnote 1 referrer