I DECLARE, since the last criminal record check provided to SMGSA, or since the last Offence Declaration, that I have no convictions under the Criminal Code of Canada up to and including the date of this declaration for which a pardon has not been issued or granted under the Criminal Records Act (Canada)
Check All That Apply
I have been convicted of the following criminal offences under the Criminal Code of Canada for which a pardon under Section 4.1 of the Criminal Records Act (Canada) has not been issued or granted to me.