NEXUS RENEWAL APPLICATION

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1 NEXUS RENEWAL APPLICATION INSTRUCTION Read the following instructions before you start: 1. Download and save the application form on your computer. 2. Complete one application form per person. Fill out all the information that applys for you. Do not leave any gaps ( incl. unemployemnt or student). 3. Make clear copies of your identity and citizenship documents. ( driver licence, passport, PR card) 4. Choose TrustedTravel Service and pay the fee via: 5. Send your complete application pack using one of the following methods: adress: service@trustedtravelprograms.com fax: (202) TE: We do not accept postal applications PayPal- $99.99 WHAT HAPPENS NEXT? 1. TrustedTravel carefully check your application form, you regarding any omissions and submit your information to the US & Canadian Border Authorities. 2. TrustedTravel pay the $50 government fee using the credit card provided by you. 3. TrustedTravel send you access details for your profile on the Trusted Traveler database. 4. You will receive an at your address informing you if you are eligible for NEXUS. If your status is Approved you can schedule your interview. 5. You attend an interview, where your original documentation is checked and biometric data is collected. The interviewing officer informs you if you are admitted to the NEXUS program. 6. You will receive your NEXUS card by mail from CBP headquarters. TERMS OF USE TE: We cannot use your credit card to pay for the TrustedTravel service fee. Read our website Terms & Conditions before submitting your application and paying our fees 1. TrustedTravel is not responsible for any delays in the submission caused by incomplete information. 2. TrustedTravel is not responsible for applicants who are denied from the program for any reason 3. TrustedTravel does not give refunds for applications submitted in error. 4. TrustedTravel has the right to contact applicants for additional information 5. TrustedTravel has the right to change the terms and conditions without any notice. TrustedTravel is not a government agency and cannot influence the outcome of your NEXUS application. By submitting the application pack and paying the service fee, each applicant agrees to the terms and conditions Check this box to agree to TrustedTravel terms & conditions Signature Transaction

2 GOES ID PASSWORD DATE PERSONAL INFORMATION SURNAME OTHER NAME (first/ middle) FIRST NAME OTHER NAME (last/ middle) MIDDLE NAME D.O.B MALE FEMALE EYE COLOR HEIGHT BIRTH COUNTRY CONTACT DETAILS CITY OF BIRTH BIRTH STATE HOME PHONE OR CELL # ADDRESS List a contact information that will be cheched regularly for status updates. List ONLY 1 . CITIZENSHIP & NATIONALITY US CITIZEN CANADIAN CITIZEN MEXICAN CITIZEN PERMANENT RESIDENT OTHER PASSPORT # COUNTRY VISA # TYPE COUNTRY PR CARD # COUNTRY NAME ON PASSPORT / PR CARD DRIVERS LICENCE INFORMATION ATTACH CLEAR SCANNED COPIES OF YOUR DOCUMENTS TO YOUR APPLICATION DRIVERS LICENCE NUMBER NAME ON LICENCE VEHICLE INFORMATION MAKE MODEL YEAR VIN NUMBER LICENCE PLATE STATE WHERE LICENCE PLATE WAS ISSUED OWNER OWNER ADDRESS OWNER PHONE OWNER D.O.B

3 ADDRESS HISTORY FOR THE LAST FIVE YEARS CURRENT ADDRESS FROM (YYYY/MM) Is this your mailing address? MAILING ADDRESS IF DIFFERENT TO YOUR CURRENT ADDRESS FROM (YYYY/MM) ADDRESS HISTORY FOR THE LAST 5 YEARS

4 EMPLOYEMENT HISTORY FOR THE LAST FIVE YEARS CURRENT EMPLOYEMENT STATUS SELF IF YOU ARE A,, OR PLEASE CHECK THE RELEVANT BOX. YOU DO T HAVE TO FILL OUT MORE DETAILS OTHER THAN THE FROM AND TO DATES. EMPLOYMENT HISTORY FOR THE LAST 5 YEARS SELF SELF SELF SELF

5 TRAVEL HISTORY FOR THE LAST FIVE YEARS List the countries you have traveled to; other than the United s, Canada, and Mexico within the past 5 years ADDITIONAL INFORMATION Have you ever been convicted of an criminal offense in the U.S. or any other country? Have you ever received a waiver of inadmissibility to the U.S from a U.S government agency? Have you ever been approved for rehabilitation because of past criminal activity/violation? Have you ever been found in violation of customs or immigration laws? PARENT / GUARDIAN DETAILS FOR APPLICANTS (under 18 years of age) Parent or Guardian Name Phone # Date of Birth (yyyy/mm/dd) Relationship to the applicant MEXICAN CITIZENS MUST PROVIDE ALSO: U.S. CONTACT: FULL NAME: AS OF DATE yyyy/mm: PHONE #

6 FEE PAYMENT Your credit card details are required for the certification of your application with US Customs and Border Protection (CBP). The government Fee is USD $50. T rustedtravel Service fee is payable via PayPal. By submitting the application pack and paying the service fee, each applicant agrees to the terms and conditions Check Box to confirm that you have paid TrustedTravel Service fees via PayPal Check this box to agree to TrustedTravel terms & conditions ALL CREDIT CARD INFORMATION IS DESTROYED ONCE GOVERNMENT FEES ARE PAID CREDIT CARD # NAME ON CARD CVV CODE CVV CODE IS THE 3/4 DIGIT NUMBER PRINTED ON THE BACK OF YOUR CREDIT/DEBIT CARD CERTIFICATION I certify that all information given by me on this application form was provided voluntarily and is true and complete. I understand that all the information on this application, including the supporting documentation, background information and biometric data will be shared among customs and immigration authorities in both Canada and the US, and among law enforcement and other government agencies with applicable laws. I certify that I have read, understood and agree to all terms and conditions required for use of the NEXUS program, including all instructions and notices. Signature PRINT NAME DATE TE! WRITE CLEARLY AND LEGIBLY. WE CANT PROCESS YOUR APPLICATION IF WE DO T HAVE A FULL FIVE YEARS ADDRESS AND WORK HISTORY. Your application MUST signed terms & conditions, which makes up the first and last pages of the NEXUS application form.

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