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Spreadsheet / Type of Change specify your reason for this Family Name (required)
Change Requested change

Please Specify: Initial

Please provide a detailed reason for As listed in passport minus any tildas or
DD-MMM-YYYY Attendee, Addition or
this change hyphens
Withdrawal

14-Jul-2023 Initial Attendee N/A Lopez

Initial Attendee
 Date of Birth (required)

Is this individual
inadmissible into
Gender Country of Birth
Given Name(s) (required) Canada under Year Month Day
(required) (required)
Canada's
Immigration law?

Please Please Please Please

As listed in passport minus any tildas or
Please Select from List Select from Select from Select from Select from Please Select from List
hyphens
List List List List

Orlando No Male 1991 September 13 Colombia

No
 Passport Issue Date (required) Passport Expiration Date (required)

Country of Citizenship Passport Number

Year Month Day Year Month
Residence (required) (required) (required)

If starts with "0" put a

semi colon (;) before Please Please Please
Please Select Please Select
Please Select from List Please Select from List the 0. Any spaces in Select from Select from Select from
from List from List
number should be List List List
included

Colombia Colombia AX770127 2021 October 20 2031 October

xpiration Date (required)

Does this worker

Expected date to start
have a USA In what country is
working in Canada
Day permanent resident this worker Job Title (required)
(required if earlier than
card (Green Card)? currently?
vessel arrival)
(required)

Please
required if TRV
Select from Please Select from List DD-MMM-YYYY
application
List

20 No Colombia Thermic insulation 18-Sep-2023

No September 18, 2023

Expected duration of time working
Minimum education requirements
in Canada (required if earlier than Main Duties of the Job (required)
of job (required)
vessel arrival)

List a detailed description of the main

Time spent working in Canada duties that the worker will be Please Select from List
completing.

Removing and replacing of old

2 weeks Secondary School
pipe insulation.

2 Weeks
 Is this employee
Experience and skills required to Name of company paying foreign
Other Training Required subcontracted?
complete the job duties (required) national directly (required)
(required)

Examples of other certifications

needed: First Aid certificates / Please specify the legal name of the
Please Select from List
Workplace Safety certificates, specialty company paying this individual
training.

Tracing and cutting on pipe and Previous work experience in

metal layer,intalation of hot and carpet installation (3-5 years yes Tecnavi
cold insulation systems minimum)

Previous work experience in

HVAC system installation (3-5 Yes
years minimum)
 Wage Amount - Number of work Overtime rate in
Is this employment
Type of Wage (required) Canadian Dollars hours per day Canadian Dollars
Seasonal? (required)
(required) (required) (required)

Please Select from List Please Select from List

Wage in Canadian Dollars Per

No 17.00 10 35.00
Hour

se tiene que indicar

cuanto ganan por
hora teniendo en
cuenta que el
Wage in Canadian Dollars Per minimo debe ser
No 10 35
Hour 16,65 dolares
canadienses (Pomer
lo que se les paga
en dolares
canadienses)

Benefits - Please state all that
apply from (Disability Insurance,
Overtime starts after
Dental Insurance, Pension,
how many hours per
Extended Medical Insurance)
week (required)
(Required if any, otherwise select
none)
Please Select from List
Dental Insurance, Extended
50
Medical Insurance
50
Please provide this information to seaspan as s
This information will be provided to Canadian B
for work permit issuance THIS MUS
First Canadian Port
Other Benefits (if applicable).
Transport
Please Specify: (Required if any)
Method
Please Select from List
Meals and accommodation
Airport
provided during project
Meals and accommodation
Airport
provided during project
 provide this information to seaspan as soon as known
formation will be provided to Canadian Border Service Agency Officers
for work permit issuance THIS MUST BE ACCURATE

First Canadian
First Canadian Port First Canadian Port
Port
Arrival Arrival
Flight Number
Location Date
(if applicable)

First Canadian entry First Canadian entry First Canadian entry

Calgary 28-Sep-18 EZ123

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