BSF911 – Release and B3 Declaration Electronic Data Interchange (EDI) Application Form

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 (724 KB) [help with PDF files]

The information you provide in this document is collected under the authority of the Customs Act-sections 32 and 33 for the purpose of risk assessment and determining admissibility and collecting trade data and assessing duties and taxes on imported commercial goods. The information may be disclosed to Canadian Food Inspection Agency , Canadian Nuclear Safety Commission, Environment and Climate Change Canada, Fisheries and Oceans Canada, Global Affairs Canada, Health Canada, Natural Resources Canada, Public Health Agency of Canada, Transport Canada, Statistics Canada, the Canada Revenue Agency or the Royal Canadian Mounted Police for the purpose of program administration. Submission of any commercial trade data and personal information as part of your EDI transmission constitutes your consent and acknowledgement that you, as an importer or licensed customs broker, have informed all individuals whose personal information is listed in your transmission with proper and adequate privacy protection notices and that you have secured their consent to the collection use retention and disclosure of this personal information by the Canada Border Services Agency. Individuals have the right to access and to make corrections of their personal information under the Privacy Act. The information collected is described within the Carrier and Cargo Program Personal Information Bank PPU 045,the Food, Plant and Animal (FPA) Program Personal Information Bank CBSA PPU 062, Administrative Monetary Penalty System Program Personal Information Bank CBSA PPU 001, which is detailed at within the Information about Programs and Information Holdings (formerly Info Source). Should you have concerns about the CBSA's handling of your personal information you have a right to file a complaint with the Office of the Privacy Commissioner of Canada.

Section 1– Applicant Information

For which system are you applying (check all that apply)

CADEX B3 Declaration (CBSA proprietary)

ACROSS electronic release (CBSA proprietary)

CUSDEC B3 Declaration (EDIFACT)

ACROSS electronic release (EDIFACT)

CADIFACT B3 Declaration (EDIFACT CADEX Wrapped)

ACROSS electronic release (CADEX Wrapped)

Please note that for Daily Notices (DN) and Statement of Account (SoA), you must complete a separate application form. You will find the DN & SoA application form at https://www.cbsa-asfc.gc.ca/prog/arl-glcc/menu-eng.html.

Note: Clients must be CADEX or CUSDEC participants in production to apply for ACROSS

Company Profile

Date of application

Name of applicant (company)

CBSA-issued Account Security number

Registration Number (BN)

Address

City / Province

State / Country

Postal / Zip code

Contact person

Title

Telephone Number

e-mail

Afterhours Contact Person

Title

Afterhours Contact Telephone Number

Afterhours Contact e-mail

Section 2 – Communication Method Information

For more information on the approved communication methods, please consult the following link: www.cbsa-asfc.gc.ca/eservices/comm-eng.html

If your company will be using a service provider to exchange data with the CBSA, please complete this block

Method of communication

Contact person

Telephone

e-mail

If your company will be exchanging data directly with the CBSA, please complete this block

Method of communication

Section 3 – Configuration

Certificate number in production (if transmitting through Customs Internet Gateway)

Certificate number in test (if client is testing and transmitting through Customs Internet Gateway)

Sender identification (client defined, or transmission site if desired [U99999V1])

Mailbox ID, if applicable

In which official language do you wish to receive your output transmissions?

Requested implementation date

Section 4 – B3 Declaration Profile Information

Password in test (<= 8 characters)

Password in production (<= 8 characters)

Central accounting office (CBSA office code number)

Office(s) of release which you will be including in your B3 entry transmissions. (Should you wish to release at more than one office, you must have the proper level of security posted with the Agency.)

Which file updates would you like to receive to support your preparation of accounting documents?

Section 5 – Certification

This form must be signed by an authorized person of the business such as an owner, a partner of a partnership, or a director of a corporation. By signing and dating this form, you authorize the CBSA to deal with the individual(s), or firm(s) listed in Section 2 of this form.

Language

Email

Telephone

Authorized Person's Name

Title

Signature

Date (yyyy-mm-dd)

Completed forms can be sent:

Manager, Technical Commercial Client Unit
Program Business System Integration
Canada Border Services Agency 355 North River Road, 6th Floor, Tower B
Ottawa, Ontario
K1A 0L8
via e-mail: tccu-ustcc@cbsa-asfc.gc.ca

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