To begin your waiver renewal please complete the forms included in this document and return to the

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1 Subject: Renewal of United States Entry Waiver Dear Client, It is time to renew your US Entry Waiver. In order to avoid any periods of inadmissibility to the United States it is very important that you submit your new application to Customs and Border Protection well before your previous waiver expires. Please keep in mind that it will take the National Pardon Centre several months to obtain all of the documents needed to complete your application. We strongly advise that you begin the process immediately. To begin your waiver renewal please complete the forms included in this document and return to the National Pardon Centre. If you need to obtain a new set of fingerprints from your nearest local police station or fingerprinting agency please forward them directly to us ASAP. If your address, employer, or marital status has changed since your last waiver application you will need to inform us right away. Please do not hesitate to contact us should you have any questions or concerns. Sincerely, National Pardon Centre (866) info@nationalpardon.org

2 Client Information Sheet First Name: Middle: Last: Any Other Names: Sex: M / F Phone Numbers: Work: ( ) Home: ( ) Cell: ( ) Please circle the area code of any number that requires discreet contact procedures I prefer to be contacted by: Phone / Have you ever been: 1. Questioned about your criminal record at the border? 2. Refused entry to the United States? 3. Deported from the United States? 4. Arrested in the United States? If you have answered yes provide brief explanation: 1. Have you served in the Cdn Forces? 2. Are you currently serving? 3. If Yes provide unit address: 4. If Yes provide Military #: Date of Birth: (YYYY/MM/DD): Place of Birth (City/Prov/Country): Drivers License #: Province of Origin: Please provide a copy of TWO pieces of government issued ID with your application. If born outside Canada indicate your current immigration status: Your address must account for the last 10 years. Attach additional sheet or use the back of this form if necessary. Current Mailing Address: Date Moved In (YYYY/MM): Moving Soon? Previous Mailing Address: Date Moved In (YYYY/MM): Date Moved Out (YYYY/MM): For a Pardon we require your current employer only. For a US Waiver we require employer details for the past 5 years. Attach additional sheet or use the back of this form if necessary. Current Employment (Name and Address): Work Start Date (YYYY/MM): Job Title: Previous Employment (Name and Address): Start (YYYY/MM) : End (YYYY/MM): Job Title:

3 Required Documents for USA Entry Waiver Application The following items are required for your application to enter the United States. Please be advised that these items are not immediately required when starting your application. If you have not yet returned a set of fingerprints as well as all other forms to the National Pardon Centre, please do so at your earliest convenience. If you need more information or have any questions, feel free to contact us. 1. Identification Please provide us with a copy of your Canadian passport. If you are not a Canadian citizen, please contact one of our counsellors as soon as possible. 2. Applicant s letter Please provide us with a personal letter detailing your infractions as well as your reasons for applying for an entry waiver. Your letter should include the following information: - The circumstances surrounding each infraction on your record (when, why, and how each infraction was committed) or the reason of your exclusion from the United States. If you have any drug-related infraction (possession, traffic, production), include detailed information on the types of drugs, the quantity, and the location where the traffic or the production took place. Make sure to include as much detail as possible for each infraction. - The expression of your regret for committing these infractions and how your life has changed since. - Your strong ties to Canada (e.g., employment, family, friends, residence, etc.). Sign and date your letter; copies will not be accepted. 3. Proof of employment According to your personal situation, please provide us with the following: - Employed: a letter from your employer stating when you started working for them and what your functions are in the company. - Self-employed or the owner of a business: a letter explaining since when you acquired this function and what your activities are. - Student: proof of your status, that is a letter from the registrar confirming your registration. - Retired: a letter indicating your retirement date and what you spend your time doing now that you are retired. - Unemployed: a letter detailing the reasons of your unemployment as well as any measures you have taken to find new employment. The letter must be signed and dated. No copies will be accepted 4. Proof of all income Please provide us with proof of all income. More precisely, please send us a copy of your most recent notices of assessment (federal and/or provincial) as well as any pertinent information on your income (investments, rental income, etc.). If you are self-employed, it is strongly advised that you send us a copy of the complete T1 declaration. 5. Reference letters Please provide us with three (3) letters of recommendation written by colleagues, friends, neighbours, etc. Please note that letters from members of your family are not accepted except for exceptional reasons. These letters must mention for how long the person has known you and attest to your good behaviour. They must be dated and signed, copies will not be accepted. Please note that identical letters signed by different persons will not be accepted. 6. Drug offences documents If you have any drug-related infractions in your record, we strongly recommend providing proof that you are drug free. Speak with a counsellor at the National Pardon Centre about this. 7. Additional rehabilitation proof (optional) You can also include any other document attesting to your rehabilitation (e.g., letter from your therapist, confirmation of participation in a therapy, confirmation of participation in AA meetings, etc.). This is especially important if you have infractions of a sexual nature in your record. 2013/08/06

4 Information Required for USA Entry Waiver Application National Pardon Centre Please complete to the best of your abilities and return this form to the National Pardon Centre Client Name: Date: Father s Full Name: Father s Place of Residence (City, Country): Father s Place of Birth (City, Country): Father s Date of Birth: Mother s Full Name (Include Maiden Name): Place of Residence (City, Country): Mother s Place of Birth (City, Country): Mother s Date of Birth: Spouse s Full Name (Include Maiden Name): Spouse s Date of Birth: Spouse s Place of Birth (City, Country): Place and Date of Marriage (City, Country, Month, Year): Former Spouse s Full Name (Include Maiden Name): Former Spouse s Date of Birth: Place and Date of Marriage (City, Country, Month, Year): Place and Date of Termination (City, Country, Month, Year): List all countries where you currently hold citizenship: Have you ever applied for a US waiver in the past? If yes, please explain when and where you submitted the application(s): Have you ever been granted a US entry waiver? If yes when? (YYYY/MM) Submitted to which port of entry? If yes, please provide a copy of your past entry waiver(s). Have you ever stayed in the United States for a period of six months or more? If yes, when, for how long, and under what immigration status? US Social Security Number (if applicable): Have you (or has someone acting in your interest) ever applied for a US immigration benefit? (Work Visa, Green Card, etc.) If yes, please provide details: Has the United States Government ever denied, refused, or revoked an immigration benefit (such as a visa)? If yes, please provide details: Have you ever been arrested or charged for any violation of law (criminal or otherwise) outside of Canada? If yes, please provide details: Please include a brief explanation of your purpose for travelling to the United States (work/travel/etc.):

5 Race/Ethnicity and physical description: Hispanic or Latino: Not Hispanic or Latino Select all that apply: White Asian Black or African American American Indian or Alaska Native Native Hawaiian or Other Pacific Islander Height (in feet and inches): Weight (in pounds): Eye colour (select one): Black Blue Brown Gray Green Hazel Maroon Pink Other Hair colour (select one): Bald Black Blond Brown Gray Red Sandy White Other Travel Information (if known): Location at which you plan to enter the United States (desired Port-of-Entry) City and State: Name of Port-of-Entry How do you plan to travel to the US? (Method of transportation): When do you plan to enter the US? (Date): Approximate length of stay in the US? If you have applied for a waiver in the past: Details on waiver use (ie. work-related trips, connecting flights, vacations):

6 SERVICE AND AUTHORIZATION AGREEMENT I authorize the National Pardon Centre to act on my behalf for the purpose of obtaining a Canadian pardon, purge and/or file destruction from the Government of Canada, and/or for the purpose of obtaining a USA Entry Waiver from the Department of Homeland Security. I give permission for the National Pardon Centre to communicate with all government offices necessary for the completion of my file, including the RCMP, regional and local police, courts, DHS and PBC in addition to any government related office that may be required. I understand that further criminal activity, occurring while my Pardon application is in process, will result in a significant postponement on my eligibility, and I further understand that any delay caused by my own activity will result in additional charges. I understand that this process cannot be guaranteed to be completed within a specific amount of time and that any time frame provided by the National Pardon Centre is an average based on current and past cases. I understand the price structure of the services provided by the National Pardon Centre and that service charges are for the preparation of applications only, and that the National Pardon Centre has no authorization in granting or refusing Canadian pardons, purges, file destructions or USA Entry Waivers. Decisions rest solely with the appropriate government bodies. Name (print): Signature: Date:

7 Premium USA Entry Waiver Service Fee $695 Support Phone Support Disbursements Fees Includedd Expedited Processing Total (+13.0% HST) = $ Payment Options: A minimum $200 0 payment is required to begin your file. Please include postdated cheques or schedule monthly credit card payments thereafter. Costs do not include Department of Homeland Security filing fee. I wish to pay the full amount. I will pay $ to start and the balance monthly at a rate of $ /month. I have included post dated cheques or money orders. Please contact me for second payment. Credit Card # Expiry Date / Signature Name on card First payment amount (minimum $200): We accept: Visa, American Express, Mastercard, cheque and money order. PLEASE DO NOT SEND CASH!