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 Information for USA Entry Waiver Please complete to the best of your abilities and return this form to the National Pardon Centre. Client Name: Father s Full Name: Father s Place of Birth (City, country) Mother s Full Name (include maiden name): Mother s Place of Birth (city, country): Spouse s Full Name (include maiden name): Spouse s Place of Birth (city, country): Former Spouse s Full Name (include maiden name): Place and Date of Marriage (city, country, day, month, year): Date: Father s Place of Residence (city, country): Father s Date of Birth: Mother s Place of Residence (city, country): Mother s Date of Birth (yyyy/mm/dd): Spouse s Date of Birth (yyyy/mm/dd): Place and Date of Marriage (city, country, day, month, year): Former Spouse s Date of Birth: Place and Date of Termination (city, country, day, month, year): List all countries where you currently hold citizenship: Have you ever applied for a US waiver in the past? If yes explain when and where you submitted the application(s) _ Have you ever been granted a US entry waiver? If yes please provide a copy of your past entry waiver(s) If yes when? (YYYY/MM) Submitted to which port of entry? 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: Purpose of travelling to the United States (work/travel/etc.) Include a brief explanation:

4 Dear Client, In order to expedite the processing of your waiver application, please provide us with the following items within the next 2 months. 1. Proof of Employment: If you are currently employed a letter from your employer and a T1 slip or notice of assessment are required. The letter should be addressed To whom it may concern. Your employer does not need to know the purpose of this letter but it should include the following details: Occupation, duration of employment and a brief description of job responsibilities. If you are not currently employed we will require proof, or a letter of explanation for one of the following: Self Employed (requires T 1 tax form) Retired (requires personal letter of explanation) Student (requires letter of registration) Unemployed (requires personal letter of explanation) 2. Drug Offence Documents If your criminal record, or the reason for your exclusion from the United States, is drug related you will be required to provide proof that you are drug free. Speak with your counselor at the National Pardon Centre. If nothing drug related exists, these documents are not required. 3. Reference Letters Please provide 3 recent letters of character reference (from friends, colleagues, etc.) explaining that you are a law abiding citizen and of good conduct. These letters should be signed in ink.

5 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:

6 Expedited USA Entry Waiver: $ HST= $ Application costs included: Application costs not included: Fingerprints (if you can visit our office) Fingerprint Certification Fee Court Request Fees Document Translations Mailing and Photocopies Fingerprints (if you cannot visit our office) DHS Submission Fee $585 USD Payable directly to the American government. This is not due until your file is ready to be submitted to DHS (Department of Homeland Security). Payment Options: A minimum $200 payment is required to begin your file. Please include postdated cheques or schedule monthly credit card payments. Otherwise we will contact you when a second payment is due. Please choose one of the following: 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 date 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 or Money order