SUBJECT MATTER:	     	
	     	
	     	
	File No.:	     	
DECLARATION, UNDERTAKING AND ACKNOWLEDGEMENT
LIMITED DISCLOSURE
WHEREAS,       (name of party consenting to limited disclosure), has filed with the Canadian International Trade Tribunal (the Tribunal) certain confidential information and has consented to limited disclosure of this confidential information under certain terms and conditions.
DECLARATION
I hereby declare that I am ordinarily resident in Canada.
UNDERTAKING
I hereby undertake:
(a)	to use the information disclosed to me under the conditions of this undertaking exclusively for the purpose of the subject proceeding;
(b)	not to divulge any information disclosed to me under the conditions of this undertaking to any person connected to the named client, customer or account, or to any other person without the written authorization of the Tribunal, for any purpose;
(c)	not to reproduce, in any manner, information disclosed under the conditions of this undertaking without prior written approval by the Tribunal, with the exception of documents that are printed directly from any electronic media issued by the Tribunal under the condition that they be remitted to counsel in accordance with clause (f) below;
(d)	not to copy to a computer, storage device or shared repository any information disclosed under the conditions of this undertaking and contained on any electronic media issued by the Tribunal, without prior written approval by the Tribunal;
(e)	to keep confidential and to protect the information disclosed to me under the conditions of this undertaking in the following manner, namely:
(1)	except in the context of a hearing before the Tribunal, I will keep the following in my office or under my control, at all times:
•	the complete set of documents provided to me under the conditions of this undertaking;
•	the complete set of documents that I have printed from any electronic media provided to me under the conditions of this undertaking; and
•	any electronic media device provided to me under the conditions of this undertaking;
(2)	I will store in a locked vault, safe or other secure storage device all documents and electronic media provided to me and containing information disclosed to me under the conditions of this undertaking when these documents and/or electronic media are not being used; and
(3)	where I am provided with electronic media issued by the Tribunal, I will not divulge any access passwords;
(f)	to remit to counsel representing me,      , (insert name of counsel/person providing limited disclosure) all paper copy materials containing information disclosed under the conditions of this undertaking, at the end of my participation in the proceeding;
(g)	to remove from any server or database all documents containing information disclosed under the conditions of this undertaking, including notes, charts and memoranda based on such information;
(h)	to report promptly to the Tribunal any violation of this undertaking; and
(i)	to inform the Tribunal immediately of any changes in the facts referred to in this undertaking.
ACKNOWLEDGEMENT
I hereby acknowledge that disclosure by me of any of the confidential information to which I have been given access could result in economic harm to       (name of party consenting to limited disclosure).
Dated at       this       day of       20     .
Signature:		
Name (Print):	     	
Company Name:	     	
Address:	     	
	     	
Telephone:	     	
Fax:	     	
E-mail: