BSF613 – Summary Reporting Program Application Form

Protected B when completed

• Original / Amendment(s) to Fields(s)
• Authorization No.

• 1. Business Information
  • Exporter Name
  • Business Number
  • Address
  • City
  • Province/State, Country
  • Postal or Zip Code
• 2. Description of the Goods
  • Origin (Province/State, Country)
  • Item description
  • HS Commodity Code
• 3. Place of exit of the goods from Canada and final mode of transportation by which the goods are transported out of Canada. List all the expected places of exit.
  • Place of Exit
  • Mode of Transport
• 4. Countries of Final Destination of the Goods
• 5. Export Controls (Summary Reporting is not to be used to report the export of goods subject to permits, licences or certificates, unless the department controlling the commodity gives written permission to the exporter. This written permission from the government department issuing the permit, licence or certificate must be included with this application.)
• Are any of the goods that your company exports subject to export controls? (Yes/No) If yes, provide a description of the goods.
  • Country of Final Destination
  • Item description
  • HS Commodity Code
• 6. Carrier Information – Name of the main carrier that transports the goods out of Canada.
• 7. Customs Service Provider - Does your company use a customs service provider to report or declare on your behalf? (Yes/No) If yes, please provide the information below:
• • Customs Service Provider Company:
  • Customs Service Provider's Business Number:
  • Customs Service Provider Company Contact Person:
  • E-mail address:
  • Telephone #:
• 8. Person Responsible for Completing Application Form
  • Name
  • Title
  • Address
    • City
    • Province/State, Country
    • Postal or Zip Code
  • E-mail address
  • Signature
  • Telephone number
  • Date (yy-mm-dd)
• 9. Company President, Vice-President or Chief Financial Officer
  • Name
  • Title
  • Address
    • City
    • Province/State, Country
    • Postal or Zip Code
  • E-mail address
  • Signature
  • Telephone number
  • Date (yy-mm-dd)

Important Information

• Summary Reporting is not to be used to report the export of goods subject to permits, licences or certificates, unless the department controlling the commodity gives written permission to the exporter. This written permission from the government department issuing the permit, licence or certificate must be included with this application.
• If this application does not apply to the entire company or corporation, the additional division(s) or subsidiaries must apply for a separate Summary Report number. These division(s) or subsidiaries must have a valid Business Number in order to apply.
• If goods are not exported within a particular month, a “NIL” report must be submitted to Canada Border Services Agency. The report must be submitted within five business days following the month, whether goods were exported or not.
• Failure to submit summary reports within five business days following the month in which the goods are exported or failure to submit true, accurate and complete reports may result in administrative monetary penalties.
• Non-compliance with Summary Reporting requirements, including reporting goods that do not qualify, may result in applicable penalties and/or termination from the Program.
• Summary Reporting participants are responsible to provide the CBSA with an amended application whenever a change to their existing application occurs.
• An approved application is valid for 2 years. You must reapply at least 90 days before the effective expiry date to continue using Summary Reporting.

Privacy Notice

The information on this form is collected under the authority of the Customs Act - Section 95 for the purpose of administering the Canada Border Services Agency (CBSA) Export Program. The personal information on this form is protected in accordance with the Privacy Act. The information may be disclosed to internal and external Government of Canada bodies for the purposes of enforcement, safety, security, statistics and intelligence.

You have the right to access and/or to correct your personal information under the Privacy Act ­Section 12. The information collected is described under the Personal Information Bank Export Program CBSA PPU 1103 which is detailed at https://www.cbsa-asfc.gc.ca/agency-agence/reportsrapports/pia-efvp/atip-aiprp/infosource-eng.html.

BSF 613 - SUMMARY REPORTING PROGRAM APPLICATION FORM - Completion Instructions

Explanation

Original, Amendment(s) to Field(s): check the appropriate box to indicate whether your application is the original document or you are making an amendment. If it is an amendment, indicate the appropriate field(s) that you are amending.

Authorization Number: Insert your existing SUM authorization number if you have one. If not, leave this blank.

Continuation sheet(s) may be included to provide the information found in fields 2, 3, 4 and 5.

Field No. 1. Enter the Exporter's Name, Address and Business Number. The Business Number (BN) is the federal government assigned number, including the six digit RM account identifier, of the company or person that exports the goods or causes them to be exported. Note: When an Administrative Monetary Penalty is issued, it will be assessed against the company whose BN appears on the form. To request a BN, visit the Canada Revenue Agency Web site at www.canada.ca/en/services/taxes/business-number.html or call 1 (800) 959-5525.

Field No. 2. If the goods are of Canadian origin, state the province from which the goods were grown, mined or manufactured. If not, state the country. If the goods are further processed imported goods or are imported goods being exported, state the province from which the goods are exported. In addition, enter the complete description of the goods in normal trade terms, and the Canadian 8-digit harmonized system export code.

Field No. 3. State the place(s) of exit through which the goods are expected to leave Canada and the final mode of transportation by which the goods are transported out of Canada. List all the expected places of exit and modes of transport. Continuations sheet(s) may be included to provide the information requested in fields 2 to 5.

Field No. 4. Enter the countries of final destination where the goods are to be consumed, further processed or manufactured, as known at the time of export.

Field No. 5. Check the appropriate box that applies. If your company exports goods subject to export controls, show the country of final destination where the goods are to be consumed, further processed or manufactured, as known at the time of export. In addition, enter the complete description of the goods, in normal trade terms, and the Canadian 8-digit harmonized system export code.

Field No. 6. Enter the name of the carrier that transports the goods out of Canada.

Field No. 7. Check the appropriate box that applies. If yes, fill in the Customs Services Provider Information.

Field No. 8. Provide the name, title, business telephone number, mailing and e-mail addresses of the person responsible for completing the application. Please sign and date.

Field No. 9. Provide the name, title, business telephone number, mailing and e-mail addresses of the Company President, Vice-President or Chief Financial Officer. Please sign and date.

Once completed, save and send form by Email to: CBSA.Export_Program-Programme_Exportation.ASFC@cbsa-asfc.gc.ca

Date modified:

2020-07-06