Please complete this form and send it to: asessments@immigrationpros.

ca
or to our fax number: 1-416-352-7412/ 1-888-897-9235
LMIA APPLICATION ELIGIBILITY INFORMATION FORM

Contact Person for preparing the LMIA

Mr./Mrs./Ms.
First and Last Name of the Contact Person:
Job Title:
Telephone number: Extension:
Fax Number:
E-mail address:
Best time to contact you:
Language of Correspondence: English ( ) French ( ) Spanish (

Company name:

Have you ever completed a Labour Market

Yes ( ) No ( )
Impact Assessment before?

If Yes, and if it was refused, please indicate the

reasons why it was refused:

Date business started:

JOB OFFER INFORMATION

Where will the Foreign Worker work? (please

Main address: ____________________________________
indicate the exact address)

If the work location involves multiple locations

due to different clients or projects please indicate
Other addresses:___________________________________
the cities names and provinces:

Number of employees currently employed

nationally under the payroll that the foreign
worker will be hired under:

Indicate the total number of full-time employees

(30+ hours per week) at the work location
specified on this form:
Indicate the total number of part-time employees
(less than 30 hours per week) at the work
location specified on this form:

Indicate the total number of temporary foreign

workers at the work location specified on this
form

How many temporary foreign workers would you

Number of TFW’s requested: ______________
like to possibly hire?

What is the position you would like to offer the

Job Title: _________________________
foreign worker(s)?

Start ______________ (YYYY-MM-DD)

For Seasonal positions, expected employment start
and end date:
End ______________ (YYYY-MM-DD)

Yes ( ) No ( )
Is the occupation regulated at a federal /
provincial / territorial level and requires
If Yes, what is the name of the certifying/licensing/registering
occupational certification, licensing, or registration?
_____________________________________

Is the position part of a union?

Yes ( ) No ( )

Please indicate the wage per hour you will pay the
Foreign Worker:
How many hours per day will the TFW work? Per day: ________

How many hours per week will the TFW work? Per week: ________

High Wage ( )
Low Wage ( )
Please indicate the stream you would like to use for
Permanent Residence ( )
this LMIA Application (if known)
Agricultural ( )
Simplified ( )

Can you prove that the company is financially able

to pay the temporary foreign worker(s) for their
entire work duration by providing: financial Yes ( ) No ( )
statements, attestation letters, CRA documents,
etc.?
 TEMPORARY FOREIGN WORKER INFORMATION

Given Name:

Last Name:

Middle Name:

Gender: Male ( ) Female ( )

Birth date (YYYY-MM-DD):

City and Country of Residence Outside Canada:

Primary Citizenship:

Secondary Citizenship:

Phone Number:

Current Address (complete address):

E-mail Address:

Highest level of education

Years of experience in the field of the LMIA
position
Temporary Foreign Worker ( )
Immigration Status: If the worker is currently in Refugee Claimant ( )
Canada indicate her/his immigration status: Visitor ( )
Student ( )
If the TFW is already in Canada, when does his /
Date (YYYY-MM-DD): ______
her status expire?