Directions:
1) Enter the required information (*).
2) Print the completed application (for your records).
3) Submit the application and proceed through the payment gateway.
________________________________________________________________________________________________
* Full Name * Other Names (your Full Legal Currently Used Name) (maiden name, previous married name(s), legal name changes, documented nick names, names stated to authorities) * Mailing Address Physical Address (needed if mailing address is different or is a PO 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 I am Self-Employed. I need to enter the U.S. for business. (Kept Confidential) * Private Email * 1st Preferred Method of Contact: Home phone Mail E-mail Work phone Cell phone Fax * 2nd Preferred Method: Home phone Mail E-mail Work phone Cell phone Fax * Are members of your household aware of this application? Yes No Married/Common Law Single
* Full Name * Other Names (your Full Legal Currently Used Name) (maiden name, previous married name(s), legal name changes, documented nick names, names stated to authorities) * Mailing Address Physical Address (needed if mailing address is different or is a PO 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 I am Self-Employed. I need to enter the U.S. for business. (Kept Confidential) * Private Email
* Full Name
* Other Names
(your Full Legal Currently Used Name)
(maiden name, previous married name(s), legal name changes, documented nick names, names stated to authorities)
* 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
I am Self-Employed. I need to enter the U.S. for business. (Kept Confidential)
* 1st Preferred Method of Contact: Home phone Mail E-mail Work phone Cell phone Fax * 2nd Preferred Method: Home phone Mail E-mail Work phone Cell phone Fax
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)
* 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 $253.00 administration fee (also includes free priority service, application tracking, email updates and express courier fees), the $50 National Parole Board filing fee, $50.00 for Document Certification fees, and $126.00 to cover 1 Court and 1 Local Police Record Search fees. Note: There will be a $70.00 biometric fingerprinting fee charged by Alberta Fingerprinting Services (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 $70, including the $25.00 mail-in or $35.00 electronic submission fee. Unfortunately, processing times for ink fingerprints are currently 6 to 8 months. Note: Additional fees will be incurred if you have multiple offenses where fines were imposed, or if you have served in the Canadian Military, or if you have lived in more than 1 city within the last 5 years, or if you were convicted of sexual and/or personal injury offences (and all long-term offenders) and you must write a Personal Letter to the NPB. Additional court record, local police record and military record searches are $60.00 each plus GST. Assistance with Personal Letters to the NPB are $120.00 plus GST. US Entry Waiver: $495.00, plus 5% GST ($24.75) = $519.75. Price includes our administration fee (includes free priority service, document certifications, application tracking, ARO update requests, email updates and express courier fees). Note: There will be a $70.00 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 $70, including the $25.00 mail-in or $35.00 electronic submission fee. Unfortunately, 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 each. Standard Canadian Pardon and U.S. Entry Waiver: Sub Total: $974.00, plus 5% GST ($48.70) = $1022.70 * NPB Priority Pardon Service: Sub Total: $120.00, plus 5% GST ($6.70) = $126.00 *NOTE: We prioritize all applications at no extra cost, however, the NPB will prioritize Pardon applications in some cases. For more information please see our FAQ Pardons Page, # 5. 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 file, plus 5% GST ($12.00) = $252.00 (see Our Fees or Pardon FAQ's for more information) If you wish to pay in Monthly Installments, please complete the box below and DO NOT proceed through our Payment Gateway. Credit Card Info: (for Monthly Installments only) Please Note: Your credit card will be billed in 2 monthly installments for Pardons or Waivers, and 4 installments for both. MasterCard or Visa Number: Expiry Date: Name on Card: Secure Code: (3 digit number on back of Visa card) * Write all Additional Addresses where you have lived in the last 10-years in the boxes below. If you are applying for a Pardon, there will be an additional $63.00 charge to cover Local Police Record Searches for each additional city/town you have lived in, within the last 5 years. Additional charges will not apply if the same police force serves each location.
Standard Canadian Pardon (removes your criminal record from CPIC): Sub Total: $479.00, plus 5% GST ($23.95) = $502.95. Price includes a $253.00 administration fee (also includes free priority service, application tracking, email updates and express courier fees), the $50 National Parole Board filing fee, $50.00 for Document Certification fees, and $126.00 to cover 1 Court and 1 Local Police Record Search fees. Note: There will be a $70.00 biometric fingerprinting fee charged by Alberta Fingerprinting Services (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 $70, including the $25.00 mail-in or $35.00 electronic submission fee. Unfortunately, processing times for ink fingerprints are currently 6 to 8 months. Note: Additional fees will be incurred if you have multiple offenses where fines were imposed, or if you have served in the Canadian Military, or if you have lived in more than 1 city within the last 5 years, or if you were convicted of sexual and/or personal injury offences (and all long-term offenders) and you must write a Personal Letter to the NPB. Additional court record, local police record and military record searches are $60.00 each plus GST. Assistance with Personal Letters to the NPB are $120.00 plus GST.
US Entry Waiver: $495.00, plus 5% GST ($24.75) = $519.75. Price includes our administration fee (includes free priority service, document certifications, application tracking, ARO update requests, email updates and express courier fees). Note: There will be a $70.00 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 $70, including the $25.00 mail-in or $35.00 electronic submission fee. Unfortunately, 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 each.
Standard Canadian Pardon and U.S. Entry Waiver: Sub Total: $974.00, plus 5% GST ($48.70) = $1022.70
* NPB Priority Pardon Service: Sub Total: $120.00, plus 5% GST ($6.70) = $126.00 *NOTE: We prioritize all applications at no extra cost, however, the NPB will prioritize Pardon applications in some cases. For more information please see our FAQ Pardons Page, # 5.
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 file, plus 5% GST ($12.00) = $252.00 (see Our Fees or Pardon FAQ's for more information)
If you wish to pay in Monthly Installments, please complete the box below and DO NOT proceed through our Payment Gateway.
Credit Card Info: (for Monthly Installments only)
Please Note: Your credit card will be billed in 2 monthly installments for Pardons or Waivers, and 4 installments for both.
MasterCard or Visa Number: Expiry Date: Name on Card: Secure Code: (3 digit number on back of Visa card)
* Write all Additional Addresses where you have lived in the last 10-years in the boxes below. If you are applying for a Pardon, there will be an additional $63.00 charge to cover Local Police Record Searches for each additional city/town you have lived in, within the last 5 years. Additional charges will not apply if the same police force serves each location.
1. , From: (MM YY) To: (MM YY) * ( PO Box Numbers are not accepted by the NPB ) 2. , From: (MM YY) To: (MM YY) 3. , From: (MM YY) To: (MM YY) 4. , From: (MM YY) To: (MM YY) 5. , From: (MM YY) To: (MM YY) 6. , From: (MM YY) To: (MM YY) 7. , From: (MM YY) To: (MM YY)
1. , From: (MM YY) To: (MM YY) * ( PO Box Numbers are not accepted by the NPB )
2. , From: (MM YY) To: (MM YY)
3. , From: (MM YY) To: (MM YY)
4. , From: (MM YY) To: (MM YY)
5. , From: (MM YY) To: (MM YY)
6. , From: (MM YY) To: (MM YY)
7. , 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 below please provide your Military ID Number, Service Dates, Address of Unit, and the Name of your Commander.
* Have you received a Pardon in the past?
* Have you ever applied for a U.S. Entry Waiver in the past?
Yes (If YES enter your A-Number, Date & Location Filed or Date and Time Period Granted)
* 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)
* Do you have a Passport? (Note: Since August of 2008 Passports have been encoded with an FPS (FingerPrint Service) number if you have a criminal record on CPIC at the time your Passport is processed.)
Yes (Year obtained or renewed)
* When were you charged or convicted of the offense(s)? Less than 1 year ago 1 - 3 years ago 3 - 5 years ago More than 5 years ago More than 10 years ago More than 15 years ago Multiple offenses in last 5 years Multiple offenses over 5 years ago Multiple offenses over 10 years ago Multiple offenses over 15 years ago Please Select
How did you hear about Alberta Pardons? Please Select Lawyer Radio Ad Referral TV Ad Newspaper Ad Travel Agent Web Search Yellow Pages Other
Comments: (please include offenses if known and any other pertinent information)
For your records please print this form before submitting & proceeding to our Payment Gateway. (Click on "File" then "Print")
Click Here if you are not automatically forwarded to our Payment Gateway after Submitting your application.
Note: Your credit card will show "ALBERTAPARD-ABFPS"
Alberta Pardons 205, 12907 - 97 Street, Edmonton, AB.
Mailing Address P.O. Box 71111 Edmonton, AB. T5E 6J8 Ph: 780-473-7171 Fax: 780-665-7371
Copyright © 2002 - 2010 Alberta Pardons. All rights reserved.