Private Investigator and/or Security Guard Individual Licence Renewal Form | Justice

Important- only the applicant can complete this form.

Please read the information on this application form carefully.The information collected is required to review and process your licence application. All required documentation must be included for the licence to be issued by the Registrar.

Please note, if you allow your license to lapse, you will be required to make a complete re-application including the results of a new Criminal Record Check and the results of a new Child Abuse Registry check which must be dated within the 6 months prior to the date of application.

Your personal information is being collected pursuant to section 6 of The Private Investigators and Security Guards Act (PISGA) and section 36 of The Freedom of Information and Protection of Privacy Act (FIPPA) to determine your eligibility for a licence under The Private Investigators and Security Guards Act (PISGA).

Any questions regarding the information collected on this form can be directed to the Registrar, Private Investigators and Security Guards Program, by email: pisg@gov.mb.ca or by phone: 204-945-2825.

Licence Type: (make one selection) Private Investigator (P/I) Security Guard (S/G) Private Investigator and Security Guard (P/I and S/G)

Licence Fees

Licence Fee (non-refundable):

Do you require a uniform exception?

Note: The uniform exemption form can be downloaded from the Private Investigators & Security Guards program webpage. A new uniform exemption form is required if you have changed employers since your last renewal.

Yes No

Attach a uniform exception form with employer signature as a .jpg or .jpeg image, no larger than 3 MB in size. The attachment must include all pages. Images must be clear and legible. Document 2

Applicant Information

Last Name:

First Name:

Middle Name:

Date of Birth:

Current P/I or S/G Licence Number:

Have there been any changes to your name? My name has changed since my licence was last issued (Proof of name change required). Criminal Record Check and Child Abuse Registry Check must include both current and previous legal name. I can confirm there have been no changes to my name since my last licence was issued.

Please indicate the following name changes:

Previous Last Name:

Previous First Name:

Attach proof of name change document (marriage certificate, divorce certificate or legal change of name certificate) as .jpg or .jpeg image no larger than 3 MB in size. The attachment must include all pages. Images must be clear and legible.

Address (must be within Manitoba):

Street Address:

City/Town:

Province:

Postal Code:

Residence Phone Number:

Cellular Phone Number:

E-mail:

Criminal Record Background

Your Criminal Record check must be renewed every three years. The Criminal Record Check results must be dated within the 6 months prior to the date of your renewal licence application.

Are you submitting a new Criminal Record check with this application? I am submitting the results of a new Criminal Record Check I am not submitting a new Criminal Record Check

Attach a new criminal record check as a .jpg or .jpeg image, no larger than 3 MB in size. The attachment must include all pages. Images must be clear and legible.

Have you been charged with or convicted of any offence since you last submitted a criminal record check result? Yes No

Offence(s)

Offence #

Offence:

Date of Offence:

City/Town:

Province/Territory/State:

Country:

Police Department:

Sentence:

Select the add button below if you have more than 1 offence(s) to include.

Please add attachment for additional offences as a photograph as a .jpg or .jpeg image, no larger than 3 MB in size.

Please Note:

You are not required to include pardoned convictions, convictions under the Youth Criminal Justice Act (Canada) and speeding or parking violations.
Please note: If your Criminal Record check results indicate that you have any criminal convictions and/or pending charges, you must include with your criminal record check results a letter or transcript from the Police Agency or Police Agencies listing the pending charges and convictions and sentences.

Criminal Record check results and transcript, must be renewed every three years.

Child Abuse Registry Background

Child Abuse Registry check results must be renewed every three years. The Child Abuse Registry Check results must be dated within the 6 months prior to the date of your renewal licence application.

Are you submitting a new Child Abuse Registry check with this application? I am submitting the results of a new Child Abuse Registry Check I am not submitting a new Child Abuse Registry Check

Attach a new child abuse registry check as a .jpg or .jpeg image, no larger than 3 MB in size. The attachment must include all pages. Images must be clear and legible.

Have you been placed on the Child Abuse Registry since last submitting a Child Abuse Registry check? Yes No

Explain:

Please Note: Child Abuse Registry checks must be renewed every three years.

Photograph

Please upload a current photograph of yourself. This photograph must be a digital or electronic file image in a .jpeg file type. The photo must be a clear image, displaying your head and shoulders with a neutral background. Any photo which is unclear, obscured by shadows, or of poor quality may be rejected and will delay the processing of your application..

Important

Photo tips:

Please ensure photos are passport quality against a neutral background (no other people, objects, signs, etc.)
Photos displaying more than your head and shoulders, that are unclear, obscured by shadows or where you are wearing hat or uniform may result in your application being rejected.
Photos must be updated every three years or whenever you have altered your appearance significantly.

Attach a photograph as a .jpg or .jpeg image, no larger than 3 MB in size.

I am not submitting a new photograph

Applicants for Dual Licence If you currently hold a Private Investigator licence or Security Guard licence and are requesting to add the other licence as part of this renewal application, proof of competency/proof of training is required for the new licence. Yes, I have proof of competency/training Not Applicable

If not applying for dual licence, return to licence type at top of page and select desired licence type.

Attach proof of competency/proof of training as a .jpg or .jpeg image, no larger than 3 MB in size.

Additional Documents Additional Documents: please attach additional document if needed.

Renewal Application

Private Investigator and/or Security Guard Individual Licence under The Private Investigators and Security Guards Act

Important