ワークパーミット申請 必要事項入力フォームトップページ




Declaration and Retainer Agreement – 免責

I hereby confirm that all the information and responses provided in this questionnaire are accurate and true to the best of my knowledge. I understand that Canada Prime Ltd will use the information contained in this questionnaire for the purpose of assisting me and my family with their application for Canadian permanent and temporary residence, and will provide this information on my behalf to the Government of Canada for such a purpose. I understand that providing false information or omitting information could result in enforcement action being taken by the Government of Canada against me, including but not limited to, a future five-year ban due to misrepresentation.

– カナダプライム正式な代理人とします。また、こちらの個人情報はカナダ移民局への申請目的に使用されることを了承します。
– 間違った情報や、必要情報を故意的に抜いたりした場合、カナダ政府の法律に沿って罰せられることを理解しております。
– カナダプライムは、ビザの許可の保証いたしません。
– お客様のビザ、永住権 却下に際し、再申請をご希望の際はコンサルテーション(1時間)は無料となりますが、その後新たな追加書類を集め、再申請をする場合は再度手数料を請求させていただきます。
– 法的に移民局へ訴える場合移民弁護士をご紹介させていただきます。(別途 弁護士費用を請求されます)

• 日本国籍以外で入国の際のビジタービザが必要な方

• ケベック州に留学したい方
• 健康診断の必要な方
• 過去に結婚歴・離婚歴のある方
• 事実婚のパートナーのいる方
• 配偶者や子供がカナダに同行する場合
• Custodian(未成年者の後見人)が必要な方 など。

RRCIC Membership Number: R511456


This Retainer Agreement is made the day you sign in this document online, between Marie Murayama ICCRC No R511456 (the RCIC), located at Site 4F 609 West Hastings Street, Vancouver, B.C. Canada and Client whom states in this online document (the “Client”), located at one written in online questioner. WHEREAS the RCIC and the Client wish to enter into a written agreement which contains the agreed upon terms and conditions upon which the RCIC will provide his/her services to the Client.
AND WHEREAS the RCIC is a member of Immigration Consultants of Canada Regulatory Council (the”Council”), the regulator in Canada for immigration consultants;
IN CONSIDERATION of the mutual covenants contained in this Agreement, the parties agree as follows:

この保持契約は、 4F 609 West Hastings Street, Vancouver, B.C. Canada に所在する村山麻理恵 ICCRC No R511456(RCIC)と、このオンライン文書に記載されている依頼者との間で、オンライン文書に署名した日に締結される。RCIC と依頼者は、RCIC が依頼者にサービスを提供する際に合意された条件を含む書面による契約を締結することを希望する。

1. Definitions
The terms “Client”, “Council”, “Disbursement” and “RCIC” shall have the meaning given to such terms in the Retainer Agreement Regulation of the Council.
1. 定義

2. RCIC Responsibilities and Commitments
The Client asked the RCIC, and the RCIC has agreed, to act for the Client in the matter of the one the client indicate within the questioner online. In consideration of the fees paid and the matter stated above, the RCIC agrees to do the following:
a)Consult the clients to inform the right and best way to apply PR or, and Temporary
b)Make sure the clients collect the right documents and application forms
c)Apply the application within 5 days after all the documents are collected
* Immigration may change its regulation without any notice. It may affect our information that the RCIC provide to the Client. If the regulation changes less than 3 days before the submission or after the submission fo the client application, the RCIC does not take responsibility for the outcome. And if the clients wish to reapply, an additional fee may be charged.
2. RCIC の責任とコミットメント
* 入国管理局の規制は予告なく変更されることがある。その場合、コンサルタントが依頼人に提供する情報に影響を及ぼす可能性がある。また、依頼者が再申請を希望する場合は、追加料金が発生する場合もあることを認める。

3. Client Responsibilities and Commitments

3.1The Client must provide, upon request from the RCIC on time.
 •All necessary documentation
 •All documentation in English or French, or with an English or French translation
3.2 The Client understands that he/she must be accurate and honest with the information he/she provides and that any
3.3 In the event Immigration, Refugees and Citizenship Canada (IRCC) or Employment and Social Development Canada (ESDC) should contact the Client directly, the Client is instructed to notify the RCIC immediately.
3.4 The Client is to immediately advise the RCIC of any change in the marital, family, or civil status or change of physical address or contact information for any person included in the application.
3.5 In the event of a Joint Retainer Agreement, the Clients agree that the RCIC may share information among all clients, as required. Furthermore, if a conflict develops that cannot be resolved, the RCIC cannot continue to act for both or all of the Clients and may have to withdraw completely.



4. Refund Policy
The Client acknowledges that the granting of a visa or status and the time required for processing this application is at the sole discretion of the government and not the RCIC. Furthermore, the Client acknowledges that fees are not refundable in the event of application refusal.
If, however, the RCIC or professional staff do not complete the tasks identified under section 2 of this agreement, the RCIC will refund part or all of the professional fees collected. In that case, the handling fee will be deducted from the total amount and the rest would be refunded. The Client agrees that the fees paid are for services indicated above, and any refund is strictly limited to the amount of fees paid. Unused fees will be refunded in the following manner. However, if the client wishes to cancel the application after this application is submitted, the professional fees will not be refundable.
In the event the Client is unable to contact the RCIC and has reason to believe the RCIC may be dead, incapacitated, etc., the Client should contact ICCRC.

依頼者は、この申請を処理するために必要な時間やビザの付与は、カナダ政府の決断であり、RCICではないことを認める。 さらに、申請が拒否された場合、世界情勢、もしくは移民局の状況などが理由でキャンセルされる場合は返金されないことを認める。
しかし、RCICまたは専門スタッフが本契約の第2項で特定された作業を完了しなかった場合、RCICは徴収した料金の一部または全部を返金する。 その際の返金手数料は、依頼者負担となる。依頼者は、支払われた料金は上記のサービスに対して支払われたものであり、返金は支払われた料金の金額に限定されることに同意するものとする。 未使用の料金は、以下の方法で返金される。ただし、本申請後に依頼者がキャンセルを希望する場合は、料金は返金されない。

5. Dispute Resolution Related to the Code of Professional Ethics
In the event of a dispute related to the Code of Professional Ethics, the Client and RCIC are to make every effort to resolve the matter between the two parties. In the event a resolution cannot be reached, the Client is to present the complaint in writing to the RCIC and allow the RCIC R511456 to respond to the Client. In the event the dispute is still unresolved, the Client may follow the complaint and discipline procedure outlined by the Council on their website under the heading “File a Complaint”. NOTE: All complaint forms must be signed.
5. 職業倫理綱領に関する紛争解決
職業倫理綱領に関連して紛争が発生した場合、依頼者とRCICは、両者の間で問題を解決するために最善の努力をするものとする。 解決に至らない場合、依頼者はRCICに書面で苦情を提出し、RCIC R511456が依頼者に回答することを許可しなければならない。 紛争が解決しない場合、依頼者は協議会のウェブサイトにある「苦情の申し立て」の見出しの下にある苦情と懲戒の手続きに従うことができる。 注: すべての苦情処理書には署名が必要となる。

ICCRC Contact Information:
Immigration Consultants of Canada Regulatory Council (ICCRC)
5500 North Service Rd., Suite 1002
Burlington, ON, L7L 6W6
Toll free: 1-877-836-7543

6. Confidentiality
All information and documentation reviewed by the RCIC, required by IRCC and all other governing bodies, and used for the preparation of the application will not be divulged to any third party, other than agents and employees, without prior consent, except as demanded by law. The RCIC, and all agents and employees of the RCIC, are also bound by the confidentiality requirements of Article 8 of the Code of Professional Ethics.
The Client agrees to the use of electronic communication and storage of confidential information. The RCIC will use his/her best efforts to maintain a high degree of security for electronic communication and information storage.
コンサルタントが審査し、IRCC及びその他の管理機関から要求され、申請書作成のために使用されたすべての情報及び書類は、法律で要求された場合を除き、事前の同意なしに、代理人及び職員以外の第三者に開示されるこはない。 またIRCCおよびIRCCのすべての代理人・職員は、職業倫理綱領第8条の守秘義務に拘束される。
依頼者は、電子通信の利用と機密情報の保存に同意するものとする。 RCICは、電子的な通信及び情報の保存について、高度なセキュリティを維持するために最善の努力を払うものとする。

7. Force Majeure
The RCIC’s failure to perform any term of this Retainer Agreement, as a result of conditions beyond his/her control such as, but not limited to, governmental restrictions or subsequent legislation, war, strikes, or acts of God, shall not be deemed a breach of this Agreement.

8. Change Policy
The Client acknowledges that if the RCIC is asked to act on the Client’s behalf on matters other than those outlined above in this Agreement, or because of a material change in the Client’s circumstances, or because of material facts not disclosed at the outset of the application, or because of a change in government legislation regarding the processing of immigration or citizenship-related applications, the Agreement can be modified accordingly.

9. Termination
9.1 This Agreement is considered terminated upon completion of tasks identified under section 2 of this agreement.
9.2 This Agreement is considered terminated if material changes occur to the Client’s application or eligibility, which make it impossible to proceed with services detailed in section 2 of this Agreement.

10. Discharge or Withdrawal of Representation
10.1 The Client may discharge representation and terminate this Agreement, upon writing, at which time any outstanding fees or Disbursements will be remitted by the Client to the RCIC.
10.2 Pursuant to Article 11 of the Code of Professional Ethics, the RCIC may withdraw representation and terminate this Agreement, upon writing, provided withdrawal does not cause prejudice to the Client, at which time any outstanding fees or Disbursements will be refunded by the RCIC to the Client/any outstanding fees or Disbursements will be remitted by the Client to the RCIC.
10.1 依頼者は、書面により代理を解除して本契約を終了することができ、その時点で未払いの申請料や未使用の手数料の支払いは依頼者からRCICに送金される。
10.2 第11条の職業倫理規定に基づき、RCICは、書面により代理を撤回し、本契約を終了させることができるが、撤回が依頼者に不利益を与えないことを条件とします。

11. Governing Law
This Agreement shall be governed by the laws in effect in the Province of B.C, and the federal laws of Canada applicable therein and except for disputes pursuant to Section 8 hereof, any dispute with respect to the terms of this Agreement shall be decided by a court of competent jurisdiction within the Province of B.C.
11. 政府の法律

12. Miscellaneous
12.1 The Client expressly authorizes the RCIC to act on his/her behalf to the extent of the specific functions which the RCIC was retained to perform, as per Section 2 hereof.
12.2 This Agreement shall be binding upon the parties hereto and their respective heirs, administrators, successors and permitted assigns.
12.3 This Agreement may only be altered or amended when such changes are made in writing and executed by the parties.
12.4 The Client acknowledges that he/she has had sufficient time to review this Agreement and has been given an opportunity. to obtain independent legal advice and translation prior to the execution and delivery of this Agreement.
In the event the Client did not seek independent legal advice prior to signing this Agreement, he/she did so voluntarily without any undue pressure and agrees that the failure to obtain independent legal advice shall not be used as a defense to the enforcement of obligations created by this Agreement.
12.5 The Client acknowledges that he/she has requested that the Agreement be written in the English language
12. その他
12.1 依頼者は、本契約の第2項に基づき、RCICがその職務を遂行するために保持した特定の機能の範囲内で、RCICが依頼者に代わって行動することを許可する。
12.2 本契約は、本契約の当事者及びその相続人、管理者、後継者、譲受人を拘束するものとする。
12.3 本契約は、当事者が書面で変更を行い、実行した場合にのみ変更または修正することができる。
12.4 依頼者は、本契約を確認するのに十分な時間があり、本契約の締結と引渡しの前に独立した法的助言と翻訳を得る機会が与えられたことを認める。
12.5 依頼者は、本契約書が英語で書かれていることを要求したことを認める。

13. Client Information
It has been indicated online form.

14. RCIC Contact
Marie Murayama Suite 460, 1140 West Pender Street Vancouver, B.C., Canada V6E 4G1
ICCRC Number R511456
Email Address: [email protected]



〒106-0032 東京都港区六本木7-8-6
TEL: 03-4405-3370


Suite460 1140 West Pender Street
Vancouver B.C. V6E 4G1
TEL: 778-580-7903


2 Bloor Street West, Suite 700
Toronto, ON M4W 3E2
TEL: 647-777-1719

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