Electronic Data Interchange (EDI) Systems
Marine Export Reporting 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. ]
Section I – Company Information
Company Profile:
- Are you a Customs Self-Assessment (CSA) Carrier? (yes/no)
- Will you be transmitting cargo reports for CSA goods? (yes/no)
- Date of application
- Name of applicant (company)
- CBSA Issued Carrier Code
- Address of company’s head office:
- City, Province
- State, Country
- Postal/Zip code
- Contact person and Title
- Telephone Number
- FAX Number
- Afterhours Contact person and Title
- Afterhours Telephone Number
- Afterhours e-mail
- In which language would you like to be assisted? (English / French)
Company Official’s Name (printed)
Company Official’s Signature
Canadian Business Office (if different from Head Office):
- Name of company
- Operating/Trade Name
- Address
City, province
Postal code - Contact person and title
- Telephone number
- FAX number
Section II – 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 is using a service provider to exchange data with the CBSA, please complete this block. Note that you will need to contact your service provider to obtain the required information below.
- Name of service provider
- Customs Internet Gateway
- Production Certificate Number
- Testing Certificate Number
- Mailbox ID: (Partner ID from the ISA or UNB segment)
- Sender ID: (Client defined application send ID, per the GS or UNB segment)
- Direct Connect / VAN
- Name of Direct Connect
- Mailbox ID: (Partner ID from the ISA or UNB segment)
- Sender ID: (Client defined application send ID, per the GS or UNB segment)
If your company will be exchanging data directly with the CBSA, please complete this block
- Method of communication
- Customs Internet Gateway
- Direct connect - name:
- Value Added Network - name:
- Mailbox ID:
Section III Agent Information
Complete this section if you have contracted the services of an Agent to act on your behalf. Please note that the obligation to provide information required by the Customs Act and any related regulation to the CBSA is the sole responsibility of the client regardless of whether an agent is used. It is your responsibility to advise the CBSA should/when you wish to cancel authorization for this agent.
- Name of Agent’s (company name)
- Address
City, province
Postal code - Contact person & title
- Telephone Number
- FAX Number
- Requested implementation date
Completed forms can be sent:
by FAX: (343) 291-5482
by mail:
Manager, Technical Commercial Client Unit
Program Business System Integration
Canada Border Services Agency
355 North River Road, 6th Floor, Tower B,
Ottawa, Ontario, Canada K1A 0L8
via e-mail: tccu-ustcc@cbsa-asfc.gc.ca
- Date modified: