Service Canada

Guide for Completion of an Application for a Labour Market Opinion (LMO) Foreign Live-in Caregiver (Form EMP5093)1
Employer # 1 Information
1. Employer ID # (if applicable) If you have previously received a confirmation or refusal letter from us, your employer ID number will be indicated on the Annex of this letter. If this is your first request, please leave this space blank. Canada Revenue Agency (CRA) business number Provide your CRA business number (9 digit code). Name (Given name(s) - Last Name) Provide your given name(s) and last name, as per official documents (e.g., birth certificate, citizenship ID, driver's licence, passport). Home Telephone Number Provide your telephone number at home. Work Telephone Number Provide your telephone number at which you can be reached during business hours. Address (Number/street/P.O. box #) Provide your complete street address or P.O box number. City Indicate the city or town where you reside. Province Indicate the province or territory where you reside. Postal Code Indicate the postal code for your residence.

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10. E-Mail Address Provide the e-mail address where you can be reached, if applicable. 11. Fax Number Indicate the fax number for sending information or correspondence, if applicable. 12. If applicable, indicate if you have provided all foreign live-in caregivers hired in the past 5 years with subtantially the same conditions (wages, working conditions, accommodations, working hours, etc.) as those that were described in the LMO confirmation letter(s) and contract(s) by checking the appropriate box. 13. Preferred official language of correspondence Indicate which of Canada's official languages should be used in correspondence with you (i.e., English or French).

Employer # 2 Information (if applicable)

If applicable, fill in information for employer # 2 as per employer #1 above by completing sections 14 to 26.

Alternate Contact Person

Note that the alternate contact person is different from the Third Party Representative noted in the following section. This section should only be completed if you wish to identify a contact person that is different from the employer # 1 and employer # 2.

1Please note that it is not necessary to return this guide as part of your application for a Labour Market Opinion.

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27. Given Name(s) Provide the given name(s) of the alternate contact person who can verify the details of the application. 28. Last Name Povide the last name of the alternate contact person who can verify the details of the application. 29. Telephone Number Indicate the phone number where the alternate contact person can be reached during business hours.

Third Party Information

Disregard this section (and the one on page 4 pertaining to third party signature) of the application if you are not securing the services of a third party. This section is applicable only to employers who have chosen to secure the services of a third party representative to act on their behalf in dealing with Service Canada. 30. Third Party ID # (if applicable) It is a reference number which is issued by Service Canada to each third party with the initial request for foreign workers. The third party who is representing you for this LMO request can provide its Third Party ID #, which can be found on any previous confirmation and/or refusal letters from Service Canada (i.e. located on both the letter and annex). However, if the third party has not been issued a Third Party ID number, or it is unknown, please leave blank. 31. Canada Revenue Agency Business Number Indicate all 9 digits for the third party company. 32. Third Party Business Name Provide the business name of the third party that will act on your behalf. 33. Third Party Representative authorized to act on behalf of employer Provide the given name(s) and last name of the contact person who will serve as the third party representative. 34. Preferred official language of correspondence Indicate which of Canada's official languages (French or English) should be used in correspondence with the third party representative. 35. Address (Number/street/P.O. box #) Provide the complete address or P.O. box number of the third party business. 36. City Provide the city or town in which the third party business is located. 37. Province Provide the province in which the third party business is located. 38. Country Provide the name of the country in which the third party company is located. 39. Postal Code Provide the postal code of the third party company. 40. Telephone Number Provide the telephone number at which the third party representative can be reached during business hours. 41. Fax Number Provide the fax number where information or correspondence can be sent to the third party representative, if applicable. 42. E-Mail Address Provide the e-mail address of the third party representative, if applicable.

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Job Offer Information

43. Expected Employment Duration Indicate the expected length of time in months or years for which you intend to employ the live-in caregiver. 44. Rationale for the job offer and explanation of employment needs being met Provide reasons for the job offered to the foreign live-in caregiver and explain how this will meet your needs in the space provided. 45. Relationship of employer to person who will receive care Indicate the relationship of the individual(s) receiving care, e.g., spouse, son, daughter, father, mother, you are designating in regards to you, the employer. Care could be for yourself. Provide details on the type of care needed: child care (children under 18), care of elderly person (seniors 65 or older), care of person with disability. If applicable, Indicate if a child or elderly person to be cared for has a disability by checking both appropriate boxes, i.e., Child care/Care of elderly person plus Care of person with disability. 46. Location where care will be provided and where live-in caregiver will reside: Provide the complete address of the actual location where the live-in caregiver will be performing the duties of the job including city, province or territory and postal code. 47. Main duties of the job Provide a detailed summary of the job duties. Service Canada expects a complete description of the work that the foreign live-in caregiver will be doing in this job. If more space is required, please attach a separate sheet to the form. 48. Language requirements Indicate language requirements for this job. One of the official languages will be a requirement for this job in Canada. If another language besides English or French is necessary for this job, identify the language and provide a rationale. 49. Wage in Canadian dollars and number of Work Hours Indicate the hourly or monthly wages (in Canadian dollars); the total number of daily, weekly and monthly total of hours of work required for the live-in caregiver, and; the overtime hour rate and the number of weekly hours after which it will start applying. 50. Benefits Indicate the benefits associated with this job such as disability insurance, extended medical insurance, dental insurance and pension by checking appropriate boxes where applicable. 51. Other benefits (specify) Specify any other benefits associated with this job. Examples of additional benefits are: providing life insurance, giving bonuses, providing a uniform, paying for meals, providing a gym membership, covering a portion of living expenses, internet, etc. Note that any benefits indicated will NOT be considered in lieu of an adequate salary. 52. Accommodation charges Indicate the accommodation charges (in Canadian dollars) and specify if this is weekly or monthly. Leave blank if it relates to a request for Quebec. 53. Meal charges If not already included under accommodation charges in box 52, indicate the meal charges (in Canadian dollars), if applicable, and specify if this is weekly or monthly. Leave blank if it relates to a request for Quebec. 54. Private furnished accommodation with lock provided Indicate if the live-in caregiver will be provided with private furnished accommodation with lock. 55. Number of paid sick leave days per year Indicate the number of paid sick days per year. 56. Number of paid vacation per year Indicate either the number of paid vacation days or the percentage vacation pay (i.e. not both) that the foreign live-in caregiver will receive per year in this job.

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57. Number of days off per week Indicate the number of days off per week. 58. Have you attempted to recruit Canadians/permanent residents for this job? Indicate whether you have attempted to hire Canadians or permanent residents for the job and provide details of recruitment/advertisement efforts. If you have not recruited (advertised), provide a detailed explanation of why you haven't recruited/advertised. If you have posted your job offer on Job Bank, please enter the job bank order number. If you have posted this job with Saskatchewan, Newfoundland, Northwest Territories or Quebec, please leave this blank. If applicable, provide copies of any other advertisements in media such as local, provincial and/or national newspapers; recognized Internet job banks; job-specific and professional publications; and job orders/postings at post-secondary or apprenticeship training institutions.

Foreign Live-in Caregiver Information

59. Name of Live-in Caregiver Provide the surname (family name or last name) and given name(s) of the foreign live-in caregiver and ensure that the spelling of the names is correct. The spelling should match exactly what is on the foreign live-in caregiver's passport. 60. Gender Indicate the gender of the foreign live-in caregiver. 61. Date of Birth (YYYY-MM-DD) Indicate the date of birth of the live-in caregiver. The date of birth you provide must match the information on the foreign live-in caregiver's passport. 62. Location of Residence outside Canada Provide the name of the country in which the foreign worker is currently living. Note that the country of residence may be different from the citizenship. 63. Citizenship Provide the citizenship of the foreign worker. Note that the citizenship may be different from the country of residence. 64. If the live-in caregiver is currently in Canada, please indicate his/her location and the immigration status If the prospective live-in caregiver is already in Canada, indicate this person's location of residence and current legal status by checking the appropriate box. The live-in caregiver should be able to provide you with evidence that he or she is in Canada legally as a visitor, or a foreign worker, or a refugee claimant or a student. Citizenship and Immigration Canada will look to ensure that the information you provide matches the live-in caregiver passport. I/we declare that I/we comply with the following statements of the Live-in caregiver Program Check boxes to indicate your agreement with each of the eleven statements.

Declaration of Employer
You as the employer (s) must sign the foreign live-in caregiver application form. Print your name(s) and write the date.

Signature of Third Party (if applicable)

If you have chosen to use the services of a third party, he/she must also sign and print his/her name and, write the date.

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Information for Employers

The following supporting documents must be sent with the application (by fax or mail) to Service Canada to complete your Application for a Foreign Live-In Caregiver: - Foreign Live-in Caregiver Application - Appointment of Representative form, if applicable - Attestation of Identity Authentication - Employment Contract - Live-in Caregiver Bedroom Description - Option-C Print-Out - Proof of age, if care is for children: long-form birth certificate or adoption certificate, or medial doctor's note confirming the pregnancy and due date of the child - Proof of age, if care is for senior people: one of the following: copies of birth certificate showing the date of birth, passport, old age security card - Medical Disability Certificate, if applicable - Copies of advertisements, if applicable - Checklist

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