ESDC EMP**** (****-**-***) E Page * of **

Emploi et

Développement social Canada

Employment and

Social Development Canada

PROTECTED WHEN COMPLETED - B

LABOUR MARKET IMPACT ASSESSMENT APPLICATION

AGRICULTURAL STREAM

Employers should visit the Temporary Foreign Worker (TFW) Program website, to verify that the Program is accepting applications for the specific occupation or sector for which they wish to hire the temporary foreign worker (TFW) and to determine if they are eligible to participate in the Program. Privacy Notice Statement

The personal information that you provide is collected by Employment and Social Development Canada (ESDC) under the authority of the Immigration and Refugee Protection Act

(IRPA) and the Immigration and Refugee Protection Regulations (IRPR), for the purpose of administering and enforcing the Temporary Foreign Worker (TFW) Program. The information that you provide may be shared with: Immigration, Refugees and Citizenship Canada and the Canada Border Services Agency for the administration and enforcement of the TFW Program and IRPA/IRPR; the Canada Revenue Agency for the administration and enforcement of the TFW Program; and, provincial/territorial governments for the administration and enforcement of provincial/territorial legislation and programs. The information may also be used by ESDC for research and evaluation purposes and to support the administration or enforcement of other programs in ESDC, including Service Canada and the Labour Program. This information may also be shared with any Party identified by the employer on the LMIA application form or in the employment agreement. Your personal information is administered in accordance with the IRPA, IRPR, the Privacy Act, the Department of Employment and Social Development Act (DESDA) and other applicable laws. You have the right to the protection of, access to, and correction of your personal information, which is described in Personal Information Banks: TFWP ESDC PPU 440 and TFW Program Employer Compliance Reviews and Inspections ESDC PPU 715. Instructions for obtaining this information are outlined on the Treasury Board of Canada Secretariat website.

This website may also be accessed on-line at any Service Canada Centre. You have the right to file a complaint with the Privacy Commissioner of Canada regarding the institution’s handling of your personal information on the Office of the Privacy Commissioner of Canada website. A person, who contravenes a provision set out under sections 126 or 127 of the Immigration and Refugee Protection Act (misrepresentation), could be liable to a fine or to imprisonment, or to both. Also, providing inaccurate information, in the context of this application, may lead to an administrative penalty such as being ineligible to access the Program for a period of two years. SECTION 1: BUSINESS INFORMATION

1. Canada Revenue Agency Business Number

(First 9 digits are mandatory for Canadian Employers): 2. Business Legal Name (as registered with CRA):

3. Business Address (as registered with CRA):

Line 1:

Line 2: 11. Country:

10. Province/Territory/State:

12. Postal/Zip Code:

8. Mailing Address (if different from business address): 9. City: Line 1:

4. City:

6. Country: 7. Postal/Zip Code:

5. Province/Territory/State:

13. Website Address:

Line 2:

15. Organization type and structure (select all that apply): Sole proprietor Partnership Corporation Co-operative Non-profit Registered Charity 14. Date business started (YYYY-MM-DD):

SECTION 2: EMPLOYER CONTACT INFORMATION

PRINCIPAL EMPLOYER CONTACT INFORMATION (This person must be the employer or be an employee of the employer) 1. First Name: Middle Name: Last Name: 2. Job Title: 3. Telephone Number: 4. Other Telephone Number: 5. Fax Number: 6. Email Address: 7. Email Preference: 8. Language of Correspondence: Do not contact via email English French

9. Mailing Address: 10. City: 11. Province/Territory/State: Line 1:

Line 2: 12. Country: 13. Postal/Zip Code:

Ext: Ext:

Business: Other:

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16. Email Preference:

23. Is the third-party being paid by the employer to represent them for the purpose of obtaining this Labour Market Impact Assessment (LMIA)? ALTERNATE EMPLOYER CONTACT INFORMATION (This person must be the employer or be an employee of the employer) 19. Email Address: 20. Email Preference: 21. Language of Correspondence: Do not contact via email English French

Line 2: 25. Country:

24. Province/Territory/State:

26. Postal/Zip Code:

22. Mailing Address: 23. City:

SECTION 3: THIRD-PARTY INFORMATION

1. Is the employer appointing a third-party to represent them for the assessment of this Labour Market Impact Assessment

(LMIA) application? Note: The employer is responsible for all decisions made on their behalf by the third-party, for the purpose of this LMIA application. Yes If yes, continue completing Section 3: Third-party Information No If no, skip to Section 4: Labour Market Impacts 2. Canada Revenue Agency Business Number (first 9 digits are mandatory for Canadian businesses): 3. Business Legal Name (as registered with CRA): 4. Business Operating Name (if different from Legal Name): 5. Business Address: 6. City:

8. Country: 9. Postal/Zip Code:

7. Province/Territory/State:

Line 2:

THIRD-PARTY CONTACT INFORMATION (Authorized representative acting on behalf of the employer) 15. Email Address: 17. Language of Correspondence: Do not contact via email English French

18. Mailing Address

Line 1:

19. City:

21. Country: 22. Postal/Zip Code:

20. Province/Territory/State:

Line 2:

a member of the Immigration Consultants

of Canada Regulatory Council (ICCRC)

other (please describe):

a member in good standing of the ICCRC, a provincial or territorial law society, or the Chambre des notaires du Québec a member of the Chambre des notaires doing pro bono work du Québec

a member of the law society of the

following province/territory:

a family member or friend

a member of a non-governmental or a religious organization other (please describe):

Yes If yes, then which applies to the third-party? No If no, then which applies to the third-party? Membership ID:

Membership ID:

Membership ID:

14. First Name: Middle Name: Last Name: 15. Job Title: 16. Telephone Number: Ext: 17. Other Telephone Number: Ext: 18. Fax Number: 10. First Name: Middle Name: Last Name: 11. Job Title: 12. Telephone Number: Ext: 13. Other Telephone Number: Ext: 14. Fax Number: ESDC EMP5519 (2018-01-003) E Page 3 of 13

SECTION 4: LABOUR MARKET IMPACTS

3. Will hiring a TFW result in direct job 4. If yes, provide details: creation or job retention of Canadians/

permanent residents?

No Yes

5. Will hiring a TFW result in the 6. If yes, provide details: development or transfer of skills and

knowledge for the benefit of

Canadians/permanent residents?

No Yes

7. Will hiring a TFW 8. If yes, provide details:

fill a labour shortage?

No Yes

9. Please describe any other benefits to the Canadian labour market that will result from offering this job to a TFW: What was the reason for the layoffs, and which occupations were affected? 10. Were any employees laid off in

the past 12 months?

No Yes

11. If yes, how many Canadians/permanent residents? How many TFWs? 13. If yes, provide details on the impact of hiring the TFW(s) on the employer's workforce and the Canadian workforce more generally:

12. Will the hiring of the TFW(s)

requested in this application lead to job

losses, or a reduction in work hours,

now or in the foreseeable future, for

Canadian/permanent resident

employees in the employer's workforce

or to the Canadian workforce more

generally as a result of lay-offs

including those resulting from

outsourcing, off-shoring or other factors

related to utilizing a TFW?

No Yes

14. Does the business receive 15. If yes, provide details: support through Employment and

Social Development Canada/Service

Canada's Work-Sharing program?

No Yes

16. Is there a labour dispute in 17. If yes, provide details: progress at the job location?

No Yes

2. Did the business report more than $5 million (CAD) in annual gross revenue to CRA during its last tax year?

1. How many employees are employed nationally under the employer's 9 digit CRA business number?

No Yes

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SECTION 5: JOB OFFER DETAILS

1. How many TFWs is the employer applying for in this occupation? 2. What is the job title of the position being offered to the TFW(s): 3. Describe, in your own words and in as much detail as possible, the main duties of the position offered to the TFW(s): 4. Provide a rationale for the job offer the employer is making to the TFW(s) and describe how this will meet the employer's employment needs: 5. What is the expected employment start date (YYYY-MM-DD)? 6. What is the expected employment duration? day(s) week(s) month(s) year(s)

7. Why does the employer require the TFW for this duration? 8. Indicate the language requirement stated in the offer of employment: This position does not require the ability to communicate in any specific language. This position requires the ability to communicate orally in: English French English or French English and French The position requires the ability to communicate in writing in: English French English or French English and French The position requires the ability to communicate in a language other than English or French. If this option is selected, indicate the other language required for the position and provide a rationale: ESDC EMP5519 (2018-01-003) E Page 5 of 13

9. Minimum education requirements of the job:

No formal education requirement

Completion of secondary school

Master's degree

Doctorate/Ph.D.

Doctor of Medicine

Other minimum education requirements

Bachelor's degree

College level diploma/certificate

Apprenticeship, trade or vocational

diploma or certificate

Professional degreee

Describe the specific diploma/certificate, degree, Ph.D. or other education requirements that the job requires: 10. Minimum experience/skills requirements of the job (include years of experience and/or occupational designations such as CPA, RN, P.Eng.): 12. If yes, indicate the type of occupational certification, licensing, or registration and the name of the issuing body/ authority:

11. Is the occupation regulated at a

federal/provincial/territorial level and

requires occupational certification,

licensing, or registration?

No Yes

1. Business Operating Name of the primary work location: SECTION 6: WORK LOCATION

2. Describe, in your own words and in as much detail as possible, the principal business activity at the primary work location: Note: If necessary, attach a separate sheet. If the TFW will be working at multiple locations, include the business operating name, the description of the principal business activity, and the address of each additional work location. 4. Address of the primary location where the TFW will work: Line 1:

5. City:

7. Postal Code (Mandatory):

6. Province/Territory:

Line 2:

3. Describe, in your own words and in as much detail as possible, any safety concerns or hazards associated with the principal business activity or site: Not specified by employer

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SECTION 7: HOURS, PAY AND BENEFITS

1. What is the wage range for all employees currently working in this same occupation, with the same skills and years of experience, at this work location? Note: The wage range should be from the last 2 pay periods that have occurred within the 6 weeks prior to submitting the application. Lowest Wage: $/hr Highest Wage: $/hr OR

there are no employees currently working in

this occupation, with the same skills and

years of experience, at this work location

2. How many hours will the TFW work each day? 3. How many hours will the TFW work each week? 5. If yes, provide details:

6. Is the employer's job offer for a full-

time position (average of at least 30

hours per week) throughout the

duration of employment covered by this

LMIA?

9. What is the overtime wage in Canadian dollars per hour being offered to the TFW? (if applicable and must meet provincial/territorial requirements) MANDATORY: If you have entered an overtime rate you must complete the section Starting after - hours per day or hours per week or both. Starting after

7. If no, provide details:

8. What is the regular (non-overtime) wage in Canadian dollars per hour being offered to the TFW?

4. Will the TFW have an atypical

schedule without standard daily or

weekly hours?

No Yes

Overtime rate of $ per hour

hours per day

hours per week

Note: Employers must provide the calculation of an hourly wage in $CAD, even if the position is salaried, paid in foreign currency, or paid by piecework. 10. Was the wage converted from a

monthly or yearly salary, or a currency

other than Canadian dollars, or both?

11. If yes, provide calculations used to obtain hourly $CAD wage: 12. Will the TFW be paid any

contingent wages (e.g. piecework,

mileage, commissions, guaranteed

bonuses, or predictable overtime)?

13. If yes, provide details:

14. Is the position part of a union? If yes, attach the section(s) of the collective bargaining agreement that list rates of pay. 15. Benefits (additional benefits offered over and beyond the provincial/territorial requirements): 16. Vacation (must meet minimum provincial/territorial requirements): Days Remuneration

Disability insurance

Other benefits (explain):

Extended medical insurance (e.g. prescription drugs, Dental insurance Employer-provided Pension paramedical services, medical services and equipment)

(# of business days per year) (% of gross salary) N/A N/A

No Yes

No Yes

No Yes

No Yes

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SECTION 8: RECRUITMENT

Method Name of Advertising

Source Website Address (if applicable) Advertisement # Publication Date Expiry Date Proof of recruitment must be submitted with the LMIA application (i.e. copy of advertisements and information to support where, when and for how long the position was advertised).

3. How many applications/resumes were received from Canadians/permanent 4. How many Canadians/permanent resident applicants were interviewed? residents?

5. How many Canadians/permanent residents were offered the position? 6. How many Canadians/permanent residents were hired? 8. How many Canadians/permanent residents applied but were not interviewed or offered the position?

7. How many Canadians/permanent residents declined a job offer? 9. For each unsuitable Canadian/permanent resident applicant, provide a detailed explanation as to why the candidate did not meet the requirements of the position. If necessary attach a separate sheet. However, do not provide the names of the candidates (e.g. applicant #1 – has not completed the apprenticeship program and therefore cannot work as a journeyperson). 1. Is the position subject to a variation in minimum advertising requirements as listed on the TFW program website, including the Quebec Facilitated Process? 2. Did the employer try to recruit Canadians/permanent residents prior to submitting this LMIA application for this job? Note: Most program streams require recruitment efforts within the 3 months prior to submitting an application. Please refer to the website for more details. Refer to the website for guidance on the applicable recruitment or advertising variation and continue completing Section 8: Recruitment only if necessary. Variations are subject to review. Yes If yes, complete all the applicable boxes and provide the required information below No If no, explain why the employer has not attempted to recruit Canadians/permanent residents: If yes, specify the variation requested and provide a rationale for meeting its criteria: No If no, proceed to the next question

Yes

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1. List crops/commodities, acreage and harvesting method for the job that will be performed by temporary foreign workers. SECTION 9: AGRICULTURAL OPERATION DETAILS

Crop/Commodity Acreage and/or headcount of livestock Method Harvested Fully automated

Semi-automated

Hand harvested

Job does not require harvesting

Crop/Commodity Acreage and/or headcount of livestock Method Harvested Fully automated

Semi-automated

Hand harvested

Job does not require harvesting

Crop/Commodity Acreage and/or headcount of livestock Method Harvested Fully automated

Semi-automated

Hand harvested

Job does not require harvesting

Crop/Commodity Acreage and/or headcount of livestock Method Harvested Fully automated

Semi-automated

Hand harvested

Job does not require harvesting

2. Total number of Canadian/permanent resident workers in the same occupation working at the same location:

3. Total number of temporary foreign workers in the same occupation at the same location:

Expected to be employed this year/

season

Employed last year/ season Expected to be employed this year/ season

Employed last year/ season

4. If the total numbers of workers, which includes Canadian citizens, permanent residents and temporary foreign workers (TFWs) is different from last year/ season, provide an explanation

1. Is this LMIA application for replacement workers? (request to replace worker(s) who left prior to the expected employment end date): 2. If yes, respond to the following:

What is the initial LMIA # you require replacement workers for? And how many workers are currently employed under the initial LMIA? Yes

No

SECTION 10: TYPE OF REQUEST

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Employers must provide proof that the on-farm or off-farm housing has been inspected by the appropriate provincial/territorial/municipal body or by an authorized private inspector with appropriate certifications from the relevant level of government. BC only, the inspection must be approved by British Columbia Agriculture Council (BCAC) as well as validated and conducted by a BCAC sanctioned inspector who is authorized to conduct agriculture inspections for the upcoming season. If the authorized inspector or jurisdiction does not have a standard format for reporting official housing inspections, employers must ensure that Schedule F – Housing Inspection Report Seasonal Agricultural Worker Program and Agricultural Stream is used to report the results. As proof of the suitability of the housing, employers must submit a housing inspection report which demonstrates that the housing unit has been inspected within the eight month period prior to Service Canada receiving the LMIA application. Example: An LMIA application received by Service Canada on December 1, 2017 included a housing inspection report dated May 15, 2017. The housing inspection will be accepted as it was completed within 8 months of the application submission date.

SECTION 11: ACCOMMODATION

1. Physical address of housing provided to the TFW Line 1:

2. City:

4. Country: 5. Postal Code (Mandatory):

3. Province/Territory/State:

Line 2:

6. Physical address of second housing location, if applicable Line 1:

7. City:

9. Country: 10. Postal Code (Mandatory):

8. Province/Territory/State:

Line 2:

11. Housing Inspection

Housing inspection report completed within the 8 month period prior Service Canada receiving this application is included. 12. Is the employer providing on-farm or off-farm housing? On-farm

Off-farm

If the housing will be off-farm, is the occupation in which the temporary foreign workers will work a lower- skilled or higher-skilled occupation?

If off-farm and lower-skilled, complete question 13 and proceed directly to SECTION 14: DECLARATION OF THE THIRD-PARTY REPRESENTATIVE (IF APPLICABLE)

If off-farm and higher-skilled, complete question 14 and proceed directly to SECTION 14: DECLARATION OF THE THIRD-PARTY REPRESENTATIVE (IF APPLICABLE)

13. Weekly Deduction

How much will the employer deduct

per week?

Note: A maximum of $30 per week

(pro-rated for partial weeks) can be

deducted from the TFW's wage,

unless applicable provincial/territorial

labour standards specify a lower

amount.

$

Lower-Skilled

Higher-Skilled

14. Market Rent

What is the market rental rate?

$

per week

per month

15. How many temporary foreign workers is the market rental rate divided between? 16. What is the rent per temporary foreign worker? Note: The rent amount per TFW should be equal to the approximate average cost of the rental divided by the number of tenants. The rent amount cannot cost more than 30% of the TFW's gross monthly earnings.

$

per week

per month

If on-farm, complete question 13 and proceed directly to SECTION 14: DECLARATION OF THE THIRD-PARTY REPRESENTATIVE (IF APPLICABLE)

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Temporary Foreign Workers have the same rights as Canadians and permanent residents and are covered under the same labour legislation and regulations. The Government of Canada takes the health and safety of foreign workers very seriously and will not tolerate any form of abuse of foreign workers or of the Temporary Foreign Worker Program. When hiring a Temporary Foreign Worker for the Agriculture Stream of the Temporary Foreign Worker Program, Employers’ responsibilities include:

• Adhering and complying with federal-provincial/territorial legislation and regulations pertaining to recruitment, employment standards and occupational health and safety.

• Making reasonable efforts to provide a workplace that is free from physical, sexual, psychological and financial abuse and must not confiscate the temporary foreign worker’s identification.

• Ensuring that the temporary foreign worker(s) are performing the same occupation and duties as you had offered them and were reported by you during the application process.

• Wages paid during employment must remain substantially the same as the wages offered and not less favourable.

• Employers must always ensure that the TFWs they want to hire under the TFW Program are covered from the provincial/territorial workplace safety insurance provider, where required by law. In provinces/territories where the provincial/territorial legislation allows employers the flexibility to opt for a private insurance plan, employers must ensure that:

• Providing suitable accommodations and have an inspection report completed for the housing provided by the appropriate provincial/ territorial / municipal body or by an authorized private inspector with appropriate certification.

• Providing the worker with a copy an employment contract which has been signed by the employer and the worker which clearly outlines the terms and conditions of employment.

• Not recovering costs of hiring the temporary foreign worker(s) such as the LMIA fee, recruitment, etc. This also applies to any third- parties used.

• Reporting any errors or changes to an approved LMIA or the temporary foreign worker to ESDC/Service Canada.

• Retaining all documentation that relates to compliance with program acts, regulations and requirements for a period of six years beginning on the first day of employment of the foreign national.

• Giving all reasonable assistance to an officer conducting an inspection such as but not limited to: attending interviews and on-site inspections, answering questions, and providing information and documentation that relates to all Program conditions and requirements. Inspections with or without prior notice can be conducted anytime within a six-year period beginning on the first day of employment of the foreign worker.

• Employers must ensure the occupancy of each accommodation location does not exceed the maximum occupancy permitted. They must also ensure that sufficient housing will be made available for all TFWs per approved accommodation from the date of arrival to the date of departure.

• Pay for the round-trip transportation costs (for example plane, train, boat, car, bus) of the temporary foreign worker (TFW) to the location of work in Canada, and back to the TFW's country of permanent residence and where applicable, at no cost to the worker, provide day to day transportation to and from the housing to the work location. o any private plan chosen provides the same or better coverage than that offered by a province/territory; and, o all employees on the worksite are covered by the same provider with the same benefits Employers who are found non-compliant with these conditions may be subject to consequences including: warnings; issuance of negative Labour Market Impact Assessments; administrative monetary penalties; bans from the program; suspension and/or cancellation of approved labour market assessments; and/or the publishing of the business name on a public website along with details of the violation. For more details on the program requirements of the Temporary Foreign Worker Program, please visit the Hiring a Temporary Foreign Worker website .

SECTION 12: EMPLOYER RESPONSIBILITIES

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IMPORTANT: Employers must use this step-by-step checklist to ensure that all the documents required are submitted, otherwise there will be delays in processing the application.

Under this stream, employer must complete, sign (where applicable) and submit the following documents: SECTION 13: DOCUMENTATION CHECKLIST - AGRICULTURAL STREAM This Labour Market Impact Assessment application form Additional attached sheets if there was insufficient room to answer a question on the form Documentation supporting the business legitimacy. The list of required documents is available on the TFW Program website. Proof of Recruitment (Job advertisements and/or other recruitment activities) ESDC/Service Canada may request that employers submit additional proof of business legitimacy documents at a later date. Submitted documents must include where, when and for how long the position was advertised and/or the recruitment activity took place. These documents must also prove that the advertisements and/or recruitment activities are consistent with the normal practice for the occupation. Refer to the TFW program website for more details. Depending on the nature of the position and/or the province of work, a recruitment variation may apply. Proof of recruitment may or may not be required in these cases. Refer to the TFW program website for more details. Copy of the signed off-farm housing contract (if applicable) If Job Bank was not used, attach a written rationale and explanation Proof of Job Bank Advertisement

Employers must send all required documentation to the Service Canada Processing Centre responsible for processing their specific type of Labour Market Impact Assessment application.

If this application is incomplete, Service Canada staff will inform the employer that it will not be processed. Incomplete applications and supporting documents submitted will not be retained or returned to the employer. As a result, employers are advised to submit copies, not original documents.

Housing Inspection report

A complete application means that employers have:

• used the latest version of the application form

• filled out all of the required fields in all of the necessary forms

• included all of the required documentation

• signed the forms where required

Copy of the Employment Contract

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SECTION 14: DECLARATION OF THE THIRD-PARTY REPRESENTATIVE (IF APPLICABLE) Signature of the Third-party Representative Printed name of the Third-party Representative Date (YYYY-MM-DD) SECTION 15: APPOINTMENT OF THIRD-PARTY (IF APPLICABLE) The individual signing this form must have authority for either the hiring or financial decisions of the organization (e.g. owner, franchisee, general manager, or senior executive – such as VP Human Resources). FOR THE PURPOSE OF THIS LABOUR MARKET IMPACT ASSESSMENT APPLICATION: This appointment shall remain in full force and effect only for the processing of this application, unless due notice in writing of its revocation has been given to ESDC/Service Canada.

I, hereby, appoint the third-party named in SECTION 3: THIRD-PARTY INFORMATION as my representative to act on my behalf in order to obtain a Labour Market Impact Assessment from ESDC/Service Canada in order to hire a foreign national for the position described above. I, hereby, agree to ratify and confirm all that my third-party representative shall do or cause to be done by virtue of this appointment. Signature of Employer Printed Name of Employer Date (YYYY-MM-DD) Signature of Employer #2 (if applicable) Printed Name of Employer #2 Date (YYYY-MM-DD) SECTION 16: SIGNATURE OF EMPLOYER

The individual signing this form must have authority for either the hiring or financial decisions of the organization (e.g. owner, franchisee, general manager, or senior executive – such as VP Human Resources). For In-home Caregiver positions, employers must be the parent or legal guardian of the child receiving care, be the recipient of care or have a valid power of attorney for the individual receiving care. A person, who contravenes a provision set out under sections 126 or 127 of the Immigration and Refugee Protection Act (misrepresentation), could be liable to a fine or to imprisonment, or to both. Also, providing inaccurate information, in the context of this application, may lead to an administrative penalty such as being ineligible to access the Program for a period of two years. Important: Employers must immediately inform Service Canada of any changes related to the foreign worker’s terms and conditions of employment as described in the positive LMIA letter and any annexes. In accordance with the provisions of the Immigration and Refugee Protection Regulations, ESDC may conduct an inspection to verify the employer’s compliance with the conditions set out in the positive LMIA letter and annexes. As a result, this inspection could include a review of the employer’s file and if

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