Canadian Criminal Record Pardon and US Waiver Application

Printable Pardon and/or U.S. Entry Waiver Application

Directions:

1) Enter the required information (*) or print the application and fill it in by hand.

2) Print a copy of the completed application (keep one for your records).

3) Fax the application to: 780-665-7371, or mail it with your check or money order.

________________________________________________________________________________________________

* Full Name

* Other Names

(your full legal and up-to-date name)

(maiden name, previous married name(s), legal name changes, documented nick names)

* Mailing Address

Physical Address (needed if mailing address is different or is a Box #)

* City

* Province

* Postal Code

* How long have you lived at this address?

(month & year you moved in)

* Home Phone

Cell Phone

* Work Phone

* Present Employer

(Kept Confidential)

* Private Email

* 1st Preferred Method of Contact: * 2nd Preferred Method:
* Are members of your household aware of this application?
Yes

No

Married/Common Law

Single

(i.e. MAR 14, 1970)

* Date of Birth

* Male
Female

* Place of Birth

* Driver's Lic. # and Province (i.e. 55-555-555 Alberta)

* Citizenship (you must be a Canadian Citizen to get a U.S. Waiver through our office, and the same goes for Indictable Offense Pardons)

* I would like to apply for:

Standard Canadian Pardon (removes your criminal record from CPIC): Sub Total: $479.00, plus 5% GST ($23.95) = $502.95. Price includes a $319.00 administration fee (also includes application tracking, email updates and express courier fees), the $50 National Parole Board filing fee, $50.00 for Document Certification fees, and $60.00 to cover Court and Local Police Record Search fees. Note: There will be a $65.00 biometric fingerprinting fee charged by Alberta Fingerprinting Services located on the second floor (which will speed up the processing of your Certified Record). If you live outside the Edmonton area we will arrange for you to be fingerprinted at the nearest biometric fingerprinting office or your local police station. There you will have to pay between $55 and $65, including the $25.00 mail-in or $30.00 electronic submission fee. Of course ink fingerprints can still be taken by our staff or your local police detachment, however, processing times for ink fingerprints are currently 6 to 8 months. Note: Additional fees may be incurred if you have multiple offenses where fines were imposed within 15-years of your application date, or if you have served in the Canadian Military, or if you have lived in more than 1 city within the last 5 years. Additional court record, local police record and military record searches are $60.00 each plus GST.

Customized Canadian Pardon (removes your criminal record from CPIC and includes a File Destruction process which seals or destroys all trace evidence showing that you were ever arrested, charged, fingerprinted, photographed, interviewed, went to court, etc.): Sub Total: $899.00, plus 5% GST ($44.95) = $943.95. Price includes our administration fee (also includes application tracking, email updates and express courier fees), the $50 National Parole Board filing fee, $100.00 for Document Certification fees, and $60.00 to cover Court and Local Police Record Search fees, and $240.00 to cover file destruction fees. Note: There will be a $65.00 biometric fingerprinting fee charged by Alberta Fingerprinting Services located on the second floor (which will dramatically speed up the processing of your Certified Record). If you live outside the Edmonton area we will arrange for you to be fingerprinted at the nearest biometric fingerprinting office or your local police station. There you will have to pay between $55 and $65, including the $25.00 mail-in or $30.00 electronic submission fee. Of course ink fingerprints can still be taken by our staff or your local police detachment, however, processing times for ink fingerprints are currently 6 to 8 months. Note: Additional fees may be incurred if you have multiple offenses where fines were imposed within 15-years of your application date, or if you have served in the Canadian Military, or if you have lived in more than 1 city within the last 5 years. Additional court record, local police record and military record searches are $60.00 each plus GST. Note: File Destructions are usually only granted after at least 10 years have passed without any further charges, convictions, investigations or negative police interactions.

US Entry Waiver: $495.00, plus 5% GST ($24.75) = $519.75. Price includes our administration fee (includes document certifications, application tracking, ARO update requests, email updates and express courier fees). Note: There will be a $65.00 biometric fingerprinting fee charged by Alberta Fingerprinting Services located on the second floor (which will dramatically speed up the processing of your Certified Record). If you live outside the Edmonton area we will arrange for you to be fingerprinted at the nearest biometric fingerprinting office or your local police station. There you will have to pay between $55 and $65, including the $25.00 mail-in or $30.00 electronic submission fee. Of course ink fingerprints can still be taken by our staff or your local police detachment, however, processing times for ink fingerprints are currently 6 to 8 months. Note: When your application is ready to be submitted you will be required to pay a $545.00 (USD) United States Department of State filing fee (as of July 30th, 2007). This fee can be paid with US cash, major credit cards, or a money order drawn on a U.S. bank account. Note: If you were convicted of illegal drug possession, sexual assault, assault, theft over $1000 or any indictable offense(s) or crimes involving moral turpitude within the last 15 years you will also be required to submit certified court and police records for all convictions at a cost of $60 each, plus per-page court transcript fees (if required) and local police record search fees (if available), which are usually $25.00 to $45.00 each.

Standard Canadian Pardon and U.S. Entry Waiver: Sub Total: $974.00, plus 5% GST ($48.70) = $1022.70

Priority Pardon Service: Sub Total: $120.00, plus 5% GST ($6.70) = $126.00

Pardoned Record and/or Court Record Search only: Sub Total: $120.00, plus 5% GST ($6.00) = $126.00

Port of Entry Parole (for emergency travel into the U.S.): Sub Total: $240.00, plus 5% GST ($12.00) = $252.00 Note: This permit is for clients who are applying for a Standard US Entry Waiver, and who need to enter the United States for emergency life-saving medical treatment or to attend a funeral for an immediate family member ONLY. Please call our office or see our Waiver FAQ section (10 & 14) if you are unsure if you are eligible to receive such a permit.

Police File Destruction Services: $240.00 per police file, plus 5% GST ($12.00) = $252.00 (see Our Fees or Pardon FAQ's for more information)

Monthly installment plans are available upon request. Please call our office for more information.

* Write all additional addresses where you have lived in the last 5-years in the boxes below. If You have lived in other cities/towns and are applying for a Pardon, there will be an additional $60.00 charge plus GST to cover Local Police Record Searches for each additional city/town you have lived in. Additional charges will not apply if the same police force serves each location.

1. , From: (MM YY) To: (MM YY)

2. , From: (MM YY) To: (MM YY)
3. , From: (MM YY) To: (MM YY)

4. , From: (MM YY) To: (MM YY)

* Have you ever served in the Military?

Yes (For Pardons there is a $60.00 charge to cover Military Record Search fees) Note: In the Comments Section please provide your Military ID number, service dates and the name of your commander.

* Have you received a Pardon in the past and are now applying for a U.S. Entry Waiver?

Yes

* Have you ever applied for a U.S. Entry Waiver in the past?

Yes (If YES enter your A-Number, date & location filed)

* Have you ever been questioned by U.S. Customs about your criminal record, or denied entry into the U.S. because of your record?

Yes (If YES when & where were you questioned)

* What year were you charged or convicted of the last offense?

How did you hear about Alberta Pardons?

Comments: (please include offenses if known and any other pertinent information)

Please print and insert your Credit Card information. (click on "File" then "Print")

If you wish to pay in monthly installments, please call our office.

Alberta Pardons
11810 Kingsway Ave, Edmonton, AB.

Mailing Address
P.O. Box 71111
Edmonton, AB. T5E 6J8
Ph: 780-473-7171
Fax: 780-665-7371

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