Guide 5069 – Temporary Public Policy: Temporary Resident to Permanent Resident Pathway (TR to PR)
Statutory Declaration of Common-Law Union (IMM 5409)
Who must complete this form?
This form must be completed and signed by the sponsor and common-law partner, only if the latter is a co-signer on the application
- Question 1
- Write the following information in the space provided:
-
- Country of current residence
- Province/state/territory of current residence
- Name of the declarant
- Name of the declarant’s partner
- Name of city, town, village
- Name of county (if applicable)
- Name of province/state/territory
- Name of the country
- Number of continuous year(s) in a conjugal relationship
- Date of the relationship (from-to)
- Question 1A
- Check the box to indicate if you have jointly signed a residential lease, mortgage or purchase agreement relating to a residence in which you both live.
- Question 1B
- Check the box to indicate if you jointly own property other than your residence.
- Question 1C
- Check the box to indicate if you have a joint bank, trust credit union or charge card accounts.
- Question 1D
- Check the box to indicate if you have declared your common-law union under the Canadian Income Tax Act (T-1 “General individual income Tax Return”)
- Question 2
- Check the box to indicate if you have life insurance on yourself which names your common-law partner as a beneficiary.
- Question 3
- Check the box to indicate if your common-law partner has life insurance on themselves which names you as a beneficiary.
- Question 4
- If you answered “no” to questions 1 to 3, indicate other documentary evidence you have that would indicate your relationship as common-law partners
- Question 5
- SOLEMN DECLARATION
Write the following information in the space provided: -
- Name of the declarant
- Name of the declarant’s partner
- Name of the city, town, village
- Name of the county
- Name of the province/state/territory
- Name of the country
- Date (day, month, year)
- Signature of the declarant
- Signature of the declarant’s partner
- Name of the person who administered the declaration
- Select the person’s title from the choices provided
- Signature of the person who administered the declaration
