Print Form Clear Form Registration Form for Employers of Security Guards and/or Private Investigators Ministry of Community Safety and Correctional Services Part 1 - Instructions Apply Online: Save time and register online. Visit http://www.mcscs.jus.gov.on.ca/english/PSIS/AboutPSIS/PSIS_about.html Apply by Mail: • Please complete this application if you will be mailing in your application. • This form is to be completed by employers of in-house security guards and/or private investigators. • Print clearly and complete all sections of this registration form using black or dark blue ink only. Do not use correction fluid/white-out. Submit your signed and dated registration form, attach a current list of employees acting as security guards and/or private investigators and the $80 employer registration fee to : ServiceOntario Occupational Licensing Services Office PO Box 4500 Kingston ON K7L 0E1 Note: If you provide an Operating/Trade Name, you must submit a copy of your Master Business Licence. For assistance, contact a Customer Service Representative at 416 212-1650 toll-free at 1 866 767-7454 or 416 212-6319 / 1 800 268-7095 (for TTY/Teletypewriter users). You may also visit our website at http://www.mcscs.jus.gov.on.ca/english/PSIS/AboutPSIS/PSIS_about.html. Part 2 - Business Information Application Type New Registration Renewal Registration Part 3 - Business Address Operating/Trade Name (Attach a copy of your Master Business Licence) Business Name Corporation No. Ontario Business Registration No. (if renewing) Master Business Licence No./Federal Business No. (Business Name Registration No.) Unit No. Street Number Rural Route City/Town Street Name PO Box Province Business Fax No. Business Phone No. Postal Code Email Address ext. Ontario Mailing Address (if different from above) Note: All correspondence will be sent to this address Unit No. Street Number Street Name PO Box Rural Route Postal Code City/Town Company Official Last Name Province First Name Business Phone No. ext. Signature of Authorized Company Representative Position Date of Signature (yyyy/mm/dd) The information provided is collected under the authority of Section 5 of the Private Security and Investigative Services Act, 2005 (PSISA) for the purpose of registering an employer under the Act. Part 4 - Business Staffing Information Indicate the current number of employees acting as security guard(s) and/or private investigator(s) You must attach a list of the names, licence numbers and licence type of employees acting as security guards or private investigators. 008-06-008E (2015/07) © Queen's Printer for Ontario, 2015 Disponible en français Page 1 of 2 Part 5 - Payment Options Cash, credit cards and personal cheques are not accepted. Pay by attaching a bank draft, certified cheque or money order. Once a payment has been received it is non-refundable. This includes payments made towards applications that are denied due to ineligibility, returned or withdrawn. Note: If an application is returned to an applicant for correction or due to missing information, applicants have 90 calendar days to respond. If the required information is not submitted within 90 calendar days, the application is deemed closed and payment will be retained. If the required information is submitted after 90 calendar days, a new licensing fee will be required. Type of Payment (make bank draft, certified cheque or money order payable to "Minister of Finance") Bank Draft Money Order Certified Cheque 008-06-008E (2015/07) Page 2 of 2
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