Note: If you do not know your complete date of birth, please use a “*” (star sign/asterisk) to fill in the spaces for the unknown year, month or day.
Question 4 Provide your father’s personal details including his: - family name (surname or last name),
- given name(s),
- date of birth,
- town or city of birth,
- country of birth,
- date of death (if applicable).
Question 5 Provide your mother’s personal details including her: - family name (surname or last name),
- given name(s),
- date of birth,
- town or city of birth,
- country of birth,
- date of death (if applicable).
Question 6 Answer each question of the section by checking the appropriate box.If you answered “Yes” to one or more of these questions, you must write an explanation of what happened in the space provided. If you need more space, attach a separate sheet of paper. Question 7 EducationIndicate the number of years of formal education you have which you have completed at each of the levels indicated.Provide the details about each secondary and post secondary educational institution you attended, including the: - period of time that you attended the institution,
- name of the institution,
- city and country,
- type of certificate or diploma issued, and
- field of study.
If no diploma was issued, write “N/A”. If you need more space, attach a separate sheet of paper.
Question 8 Provide the details of your personal history since the age of 18, or the past 10 years, whichever is most recent.Start with the most recent information. Under “Activity”, write your occupation or job title if you were working. If you were not working, provide information on what you were doing (for example: unemployed, studying, travelling, retired, in detention, etc.). If you were outside your country of nationality, indicate your status in that country. Note: Please ensure that you do not leave any gaps in time.
Important information: Failure to account for all time periods will result in a delay in the processing of your application.
Question 9 Indicate the names of all membership or association with organizations you are or were a member of, including: - political organizations,
- social organizations,
- youth or student organizations,
- trade unions, and
- professional associations.
If you were not a member of an association or organization, do not write “not applicable”. Rather, write: “I have never been a member of an organization or association”.
Note: Do not use abbreviations. Write the city and country where you were a member.
Question 10 Indicate any government positions you have held in the past such as: - Civil servant;
- Judge;
- Police officer;
- Employee in a security organization;
- Etc.
Write “NONE” in the box if you have not been a member of an association or organization.
Include:
- the name of the country and the level of jurisdiction (examples: national, regional or municipal),
- the name of the department or the branch you worked for, and
- activities and/or positions that you held.
Note: Do not use abbreviations.
Question 11 Give complete details about your military or paramilitary service (if applicable). Provide the details of your military or paramilitary service for each of the countries whose armed forces you served in. If you were not in any military or paramilitary service, write “NONE”. Do not leave gaps in time. Question 12 Indicate the residential addresses where you have lived since your 18th birthday or the past 10 years, whichever is most recent, complete with the postal code. Do not use P.O. box addresses. Authority to disclose personal information
Declaration of applicant
Read all of the statements in all sections carefully. Sign and date in the boxes provided. By signing, you certify that you fully understand the questions asked, and that the information you have provided is complete, truthful, and correct. If you do not sign and date, the application will be returned to you.
Note: The bottom section of Schedule A should not be completed at this time.
Additional Family Information (IMM 5406)
Who needs to fill out this application form?
This form must be completed by:
- You, as the principal applicant,
- Your spouse or common-law partner (whether accompanying you to Canada or not), and
- Your dependent children aged 18 or over (whether accompanying you to Canada or not).
SECTION A
Write the personal details for:
- yourself,
- your spouse or common-law partner, (if applicable)
- your mother, and
- your father.
SECTION B
Write the personal details for your children. It is very important that you list all of your children (even if they are already permanent residents or citizens of Canada). This includes:
- married children,
- adopted children,
- children of your spouse(step-children) or common-law partner,
- any of your children who have been adopted by others,
- any of your children who are in the custody of an ex-spouse, former common-law partner or other guardian.
You must answer all questions. If any sections do not apply to you, answer “N/A”.
SECTION C
Write personal details about your:
- brother(s),
- sister(s),
- half-brother(s) and half-sister(s),
- step-brother(s) and step-sister(s).
SECTION D
After carefully reading the statements contained in this section, sign and date the declaration.