I ______________________________________________________________, representing
____________________________________________________, hereby request authorization for the Company, Agency, or individual, whichever applies, to be assigned access privileges to submit export permit applications, requests for advisory opinions, applications for International Import Certificates (IIC) and Delivery Verification Certificates (DVC) and to satisfy any multipurpose reporting requirements to Foreign Affairs, Trade and Development Canada (DFATD) using the secure on-line EXCOL (Export Controls On Line) web application.
The applicant understands that an electronic submission has the same legal force and effect as a written submission under the Export and Import Permits Act. The applicant agrees that each electronic submission made via EXCOL shall incur the same legal obligation as a paper submission for accuracy, detail, and applicant certification. The applicant will continue to be obliged to retain records pertaining to these transactions or requests and make such records available as required by the Export Permit Regulations.
Whether an application is submitted electronically or on paper, the applicant will continue to report to DFATD any material changes in the terms of these orders or other facts or intentions of the export or advisory opinions as reflected in these applications and supporting documents, whether the application/request is still under consideration or an authorization has been granted; if such authorizations are granted, the applicant will be strictly accountable for their use in accordance with the Export Permit Regulations and all terms and conditions placed on the authorizations.
The undersigned representative hereby certifies that the listedindividualsare authorized by the Company or agency to act on its behalf to submit all types of electronic transactions to DFATD via EXCOL. Please provide the following for each individual (please attach a separate sheet to list individuals.):
Unique Business Email Addres: _______________________________________________
Telephone Number: _______________________________________________________
incl. Area Code
The Company understands that it is it's responsibility to notify DFATD immediately if for any reason, the company wishes to withdraw the access rights of any individual on the above list. The company officer must notify the EXCOL Local Registrar Authority by email at email@example.com, by fax: 613-992-9397 or by telephone: au 613-944-1265, with the following information:
We remind you that participation in Export Controls On-Line (EXCOL) is voluntary. The collection of your name and business contact information (such as address, email, phone and fax) is for the purpose of EXCOL enrolment and the establishment of your secure on-line account(s) and for communications relevant to Export Controls (such as Policy Notices, system availability, etc). The data will not be used for any secondary purpose (e.g., create profiles, marketing, or follow-up research/survey) without first obtaining your explicit consent.
All the informationcollected will be retained fora minimum of 2 years and a maximum of 7 years after the last administrative use, stored within the program records of theExport Controls Division ofthe Trade Controls & Technical BarriersBureau, and noted under the following Personal Information Bank:Export Import Controls.
All personal information created, held or collected by the Trade Controls & Technical BarriersBureau (TID)of DFATD is protected under the federal Privacy Act. At any point of collection you will be asked for consent to collect your information, and you will be informed of the purpose for which it is being collected and how to exercise your right of access to that information.
I, the undersigned, on behalf of ____________________________________________ certify that all statements made and all information provided herein are true and correct.
EIPA No. _______________________________________________________________
Company name __________________________________________________________
Company address ________________________________________________________
Provinceand Postal Code __________________________________________________
Name of Company Official_________________________________________________
Titleof Company Official__________________________________________________
Unique Business Email Addres _______________________________________________
Telephone Number: ______________________________________________________
(incl. Area Code)
(incl. Area Code)