Waiver Questions – Canada Pardons & US Waivers

Secure Online U.S. Waiver Bio Information Form

Full Name *

Email Address *

Spouse's Full Maiden Name (not common-law)

Spouse's Date of Birth

Spouse's Place of BirthCity, Province, Country

Date of Marriage:

Place of Marriage:Enter City, Province, and Country

Ex-Spouse's Maiden Name

Ex-Spouse's Date of Birth

Ex-Spouse's Place of Birth:City, Province, Country

Ex-Spouse Date of Marriage:

Ex-Spouse Date of Divorce:

Ex-Spouse Place of Divorce:City, Country

Current Employer Name (Need 5 Year History) *Enter your Employer Name

Current Employer Address

Current Employer Start Date *

Current Employer Job Title *Enter your Job Title

Past Employer Name (if not employed for 5 years with current employer)Enter your Past Employer Name

Past Employer Address

Past Employer Start Date

Past Employer Job Title

Past Employer End Date

Past Employer NameEnter your Past Employer Name

Past Employer Address

Past Employer Start Date

Past Employer Job Title

Past Employer End Date

Main Purpose of Entering the USA *

Maximum amount of time you plan to stay

Have you ever filed any other US Government applications? (i.e. work permit)

Have you ever been denied a US Government Benefit? (Visa, work permit, immigration)

Have you ever been arrested in the USA?

Did you ever stay in the USA longer than 6 months?

What is your FBI A-Number (if known)

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