(DISPONIBLE EN FRANÇAIS - CIT0403 F)

PROTECTED WHEN COMPLETED - B

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APPLICATION FOR CANADIAN CITIZENSHIP - MINORS (under 18 years of age) APPLYING UNDER SUBSECTION 5(1) FOR OFFICIAL USE ONLY

UCI no.

Certificate no.

FOR OFFICIAL USE ONLY

Space reserved for applicant's label

IMPORTANT INFORMATION: • The minor (applicant under 18) must be a permanent resident. The person with custody or empowered to act on behalf of the minor should complete this form. • If the minor's parent is also applying for citizenship or is already a Canadian citizen, the form "Application for Canadian Citizenship - Minors (under 18 years of age) under subsection 5(2)" should be used. Please note that a step-parent or grandparent is not a "parent" for citizenship purposes, unless the minor has been legally adopted by the step-parent or grandparent. See the guide for specific instructions. • Do not use this form if the minor is eligible for citizenship through birth outside Canada to a Canadian parent (citizenship by descent). PLEASE PRINT IN INK OR TYPE.

1. Check the box that applies:

A A person with custody of, or is empowered to act for the minor is submitting this application B

The minor does not have access to a person to apply on their behalf and will be seeking a waiver (see section 12)

2. A Language you prefer for service:

English French

B Does the minor have special needs that require accommodation? This might include wheelchair access, sign language interpretation, or access for an assistant or service dog.

No Yes ► If yes, please indicate the type of accommodation required:

3. Has the minor applied for Canadian Citizenship before? If you submitted an application for citizenship that was returned to you as incomplete, answer “no” to this question.

No Yes ► When? Year

4. A What is the minor’s client identification (ID)# or Unique Client Identifier (UCI) as shown exactly on the minor’s most recent Canadian immigration document? Immigration documents include the Permanent Resident Card (PR Card), Confirmation of Permanent Residence, or Record of Landing.

Unique Client Identifier (UCI) B What is the minor’s name as shown exactly on the minor’s Canadian immigration document? Copy the

minor’s name exactly as it appears on their most recent immigration document: Permanent Resident Card (PR Card), or Confirmation of Permanent Residence, or Record of Landing.Family name (Last name)

Given name(s)

C Has the name or gender of the minor changed since they became a permanent resident?

No Yes

If the minor had changes to their legal name or gender, additional documents must be submitted. See Appendix A: Name Change or Appendix C: Gender Change in the Instruction Guide. Insert new legal name: Family name (Last name)

Given name(s)

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D List any other names used by the minor including name at birth, aliases and nicknames. These names will not appear on the minor’s citizenship certificate.

Family name (Last name) Given name (First name) Why was this name used?

E Who is applying on behalf of this minor?

Person who checked question 1A.

Note: You must provide evidence that you are legally empowered to act on the minor's behalf. See the instruction guide for examples of evidence Provide your contact information, if you are the person applying on behalf of the minorRelationship to minor Last name (surname/family name) Given name(s)

Name of Organization or Agency (if applicable)

No. and street Apt. no.

City/Village Province Country or Territory Postal code

Telephone number

Home/Work (Area code and number) Cell (Area code and number) Email address

If you provide your email address, we may correspond with you about the application process through email where possible.

5. A What is the minor’s date of birth as shown exactly on their most recent Canadian immigration document? Copy the minor’s date of birth as it appears on their most recent immigration document: Permanent Resident Card (PR Card), or Confirmation of Permanent Residence, or Record of Landing. Note: If the minor’s Date of Birth is incorrect, see Appendix B: Date of Birth Correction in the Instruction Guide.

Date ►(YYYY-MM-DD)

Place ►Town/City

Country or territory

B Minor's personal information

Gender ► F Female

M Male

X Another gender Height ► cm OR ft in Natural eye colour ►

6. A Minor's residential/home address (residence)

No. and street Apt. no.

City/Village Province

Country or territory Postal code

B Minor's mailing address (if different from residential/home address)

No. and street Apt. no.

City/Village Province

Country or territory Postal code

6. C Minor's telephone number(s)

HomeArea code and number

WorkArea code and number

CellArea code and number

D How long has the minor lived at their residential/home address indicated above?

Year(s) Month(s)

E Minor's email address, if applicable (If you provide your email address, we may correspond with you about the application through email where possible)

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7. A ASSESSING THE MINOR’S ELIGIBILITY

Please fill out the calculator now if you have not already done so by visiting Online Physical Presence Calculator or How to Calculate Physical Presence form (CIT 0407) Some of the information in the following section is based on the online physical presence calculator. The eligibility period is five (5) years before the date you sign the application. The minimum amount of time the minor needs to be physically present in Canada is 1095 days within the five years immediately before applying. We encourage applicants to apply with more than the minimum requirement of 1095 days of physical presence, to account for any miscalculations of absences, or any other aspect that could lower the physical presence total below 1095 days.

Is the minor eligible based on the Physical Presence Calculator to apply for a grant of citizenship?

No Yes

If you checked NO, you should wait until the minor meets the physical presence requirement before completing the application.

I will provide a signed copy of: the Online Physical Presence Calculator or the How to Calculate Physical Presence form (CIT 0407)

Enter the dates from the calculator here: The minor’s five (5) year eligibility period is from YYYY-MM-DD to YYYY-MM-DD

B What date did the minor become a permanent resident of Canada (landed immigrant)? Copy the date that the minor became a permanent resident as it appears on their most recent Canadian immigration document: Permanent Resident Card (PR Card), or Confirmation of Permanent Residence, or Record of Landing.

(YYYY-MM-DD)

C During the five (5) year eligibility period, did the minor have Temporary Resident or Protected Person status in Canada before becoming a permanent resident?

No Yes

If yes, provide details in the chart below starting with the most recent: Temporary resident status includes lawful authorization to enter or remain in Canada as a: • Visitor, • Student, • Worker or, • Temporary resident permit holder Note: If the minor was issued study or work permits while their refugee claim and/or Pre-Removal Risk Assessment (PRRA) was being assessed, these documents did not grant the minor Temporary Resident Status. You cannot claim Temporary Resident time for those periods. • Was found to be in need of protection or a convention refugee by the Immigration and Refugee Board or, • A person who received a positive decision on a Pre-Removal Risk Assessment from IRCC. Note: If you are claiming time for the minor as a Protected Person, the only time allowed is the time from when the minor received a positive Protected Person decision on their refugee claim or PRRA application until the day before they became a permanent resident.

Status (e.g. Visitor, student, worker, temporary resident permit holder, or protected person)

Date minor’s status was obtained/effective (YYYY‐MM‐DD)

Date minor’s status expired (YYYY‐MM‐DD)

D Does the minor currently, or have they ever held immigration or citizenship status in a country or territory other than Canada (this includes their country of birth)?

No Yes ► Complete details below.

Country or territory Status (e.g. student, employment/worker, refugee, permanent resident or citizen)

Date obtained/effective date (YYYY/MM)

If minor’s status is no longer valid, indicate the end date (YYYY/MM). If minor’s status is still valid indicate “current”

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E Passports and travel documents for the five (5) year eligibility period If the minor is 14 years of age or older on the date you sign the application Please submit photocopies of the biographical pages of any passports or travel documents held during the five (5) year eligibility period or since the minor became a permanent resident if this happened less than five years ago. If the minor is under 14 years of age on the date you sign the application Please submit COLOUR photocopies of ALL PAGES of passports or travel documents held during the five (5) year eligibility period or since the minor became a permanent resident if this happened less than five years ago.Do you have all of the required photocopies?

Yes No ► If no, explain why these documents are not in your possession in the box below. Note: if the passport validity was extended, include a photocopy of the page(s) containing the extension stamp.

F Are there any gaps in time during the validity period of the minor’s passports or travel documents during the past five (5) years, or since the minor became a permanent resident, whichever is more recent?

No Yes

If yes, explain why the minor’s passports or travel documents do not cover the entire period of time in the box below. If you do not provide an explanation for any period when the minor did not have a valid passport, the application will be returned to you.

G Does the minor have permanent resident status or the equivalent in any country or territory other than Canada?

No Yes ► If yes, list the country(ies) or territory(ies) and provide the dates the minor acquired this status.

Country or territory Date (YYYY/MM)

H Please list all addresses inside and outside of Canada during the minor’s entire five (5) year eligibility period. Start with the most recent.

If the minor was residing, employed or attending school outside Canada during this five (5) year period, you must also indicate all foreign addresses. If there are any missing days or periods of time, the application will be returned to you.

From (YYYY-MM-DD)

To (YYYY-MM-DD)

Apartment No. Street no. and name City/Town Province/State Country or territory Postal

code

I Minor’s Education and Work History

A) Was the minor working during the five (5) year eligibility period? Yes No

B) Was the minor attending an educational institution or participating in English/French language training during the five (5) year eligibility period? Yes No

Only if the minor is under 14 years of age on the date you sign the application Please submit photocopies of all official education records if the minor attended an educational institution in the past 5 years. Official education records are: i. Report cards; or ii. Transcripts; or iii. Attendance records Note: Student identification cards and letters from institutions, teachers or principals are not accepted as official education records. Home schooling If the minor was home schooled in the past 5 years, submit photocopies of written proof of registration as determined by the respective Ministry of Education in the province or territory where you live.

Do you have all of the required photocopies of official education records? Yes No

If no, explain why these documents are not in your possession in the box below.

Note: Minors 14 years of age and over on the date you sign the application are not required to submit education records upfront with the application.

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C) Tell us what the minor has been doing during their five (5) year eligibility period. Enter details of education and employment history below. Please include any periods of not attending school or unemployment. Start with the most recent dates. If there are any missing days, periods of time or if the section is left blank, the application will be returned.

From (YYYY-MM)

To (YYYY-MM) Education/Work School attended or employer City, Country or territory

J Income tax information

A) Does the minor have a Social Insurance Number (SIN), Temporary Tax Number (TTN), and/or Individual Tax Number (ITN)?

Provide the most recent federally issued 9-digit number used to file the minor’s income taxes so that we may verify with Canada Revenue Agency:

Yes

No, I declare that the minor does not have a SIN, and ITN or a TTN and was not required to file income taxes for any of the past five (5) taxation years.

B) Tell us when the minor filed taxes in the last five (5) years using the chart below.

Taxation year Required to file Taxes filed

Yes No Yes No

C) SIN, ITN OR TTN RELEASE TO THE CANADA REVENUE AGENCY (CRA) I authorize IRCC to disclose the minor’s SIN, ITN or TTN, as the case may be, to the CRA for the purpose of requesting the minor’s income tax information and filing history from the CRA. Additionally, I authorize the CRA to disclose the minor’s income tax information and filing history from the CRA’s Income Tax and Benefit Return file to IRCC for the taxation year(s) indicated above for the purpose of assessing the minor’s citizenship application against the tax filing requirement of subparagraph 5(1)(c)(iii) of the Citizenship Act and the physical presence requirement of subparagraph 5(1)(c)(i) of the Citizenship Act. With this consent to the sharing of the minor’s income tax filing history between IRCC and Canada Revenue Agency (CRA), IRCC will use this information to determine if the minor meets the income tax filing requirement and physical presence requirement of the Citizenship Act. Note that if you do not provide your consent for these specific purposes, the minor’s application will be returned as incomplete and will not be processed. I also authorize IRCC to examine the minor’s tax information in activities to support quality assurance and integrity in the citizenship program.

Yes No

K Residence outside Canada

In the five (5) years immediately before the date of the application, or since the minor became a permanent resident, whichever is most recent:

A) Did the minor reside outside Canada with a parent, spouse or common-law partner who Yes No

• was a permanent resident, and • was employed in or with the Canadian Armed Forces, the federal public administration or the

public service of a province, otherwise than as a locally engaged person?

B) Did the minor reside outside Canada with a Canadian spouse or common-law partner who wasYes No

employed in or with the Canadian Armed Forces, the federal public administration or the public service of a province, otherwise than as a locally engaged person?

If you have answered yes to any of the above questions, complete the Residence outside Canada form (CIT 0177) and submit it with the minor's application. If you checked NO to both questions above, please continue to the next question.

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8. PROHIBITIONS UNDER THE CITIZENSHIP ACT

Certain conditions outlined in the Citizenship Act may affect a minor’s application for citizenship. Answer all of the questions by checking yes or no. For any yes responses provide details for the minor. See the situations that prevent a person from becoming a Canadian citizen.

A Is the minor now:

• on probation? ► No Yes

• on parole? ► No Yes

• serving a term of imprisonment? ► No Yes

B Is the minor now serving a sentence outside Canada for an offence? ► No Yes

C Is the minor now charged with, on trial for, or subject to or a party to an appeal relating to an offence under the Citizenship Act or an indictable offence in Canada? ► No Yes

D Is the minor now charged with, on trial for, or subject to or a party to an appeal relating to an offence committed outside Canada? ► No Yes

E Is the minor now, or have they ever been, under a removal order (has the minor been asked by Canadian officials to leave Canada)? ► No Yes

F Is the minor now under investigation for, charged with, on trial for, subject to or a party to an appeal relating to or have they ever been convicted of a war crime or a crime against humanity? ► No Yes

G In the five (5) years immediately before the date of the citizenship application, was the minor prohibited from being granted citizenship or taking the Oath of Citizenship because of misrepresentation or withholding material circumstances? ► No Yes

H In the 10 years immediately before the date of application, was the minor’s Canadian citizenship taken away (revoked) for reasons of false representation, fraud, or knowingly concealing material circumstances? ► No Yes

I In the four (4) years immediately before the date of the citizenship application, has the minor:

• been convicted of an indictable offence under any Act of Parliament or an offence under the Citizenship Act? ► No Yes

• been convicted of an offence outside Canada, regardless of whether they were pardoned or otherwise granted amnesty for the offence? ► No Yes

J While a permanent resident, has the minor:

• been convicted in Canada of terrorism, high treason, treason, or spying offences? ► No Yes

• been convicted outside Canada of terrorism? ► No Yes

• served as a member of an armed force of a country or organized armed group and that country or group engaged in armed conflict with Canada? ► No Yes

K I am the person authorized to submit this application and I have read and understand the prohibitions under the Citizenship Act.

L If you have checked "YES" to any of the questions listed above, provide details below. The minor may need to provide fingerprints and/or court documents and/or attend an in-person interview to make sure they are not prohibited under the Citizenship Act. If an interview is required, you and the minor must both attend.

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9. CONSENT TO DISCLOSE PERSONAL INFORMATION

A CONGRATULATORY LETTER

Request for authorization Federal Members of Parliament (MPs) send a letter of congratulations to new citizens in their ridings. Do you authorize IRCC to forward the minor's name, residential address and preferred official language to their Member of Parliament? No other information will be forwarded.

Yes No N/A

This information will be disclosed once you acquire citizenship.

B HISTORY OF ENTRIES TO CANADARequest for authorization By selecting "YES" in the box below, and by signing this form, I hereby give my consent to the Canada Border Services Agency (CBSA) to disclose the details of the minor's history of entries into Canada to IRCC in order to assist IRCC in determining the minor's citizenship eligibility. I also hereby authorize IRCC to collect the history of the minor's entries into Canada from the CBSA.

Yes No

Please do not contact the CBSA to request your history of entries.

10. Oath of citizenshipIf the minor is under 14 years of age, check the box to indicate if they would like to attend a citizenship ceremony. ► Yes No

Note: Minors 14 years of age and over must take the oath of citizenship. Minors under 14 years of age are not required to attend a citizenship ceremony to take the oath of citizenship and generally, citizenship certificates are mailed to the applicant.

11. APPOINTMENT OF A REPRESENTATIVEIs someone helping you fill out this form? ► Yes No

Are you paying someone to help you fill out this form? ► Yes No

If yes, to either question above, complete the following details about the person helping you:

Family name (Last name)

Given name(s)

Company name

Note: A representative can be paid or not. If your representative is paid, they must be a member in good standing of: a law society of a province or territory, the Chambres des notaires du Québec, or the Immigration Consultants of Canada Regulatory Council (ICCRC)

Would you like to name a representative (such as an immigration or citizenship consultant, lawyer, friend or family member) to do business with us for the minor? ► Yes No

If yes, the Use of Representative form (IMM 5476) must be completed and included with your application.

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12. SIGNATURES

Signature of PERSON WITH CUSTODY OR

EMPOWERED TO ACT ON MINOR'S

BEHALF

I agree to advise Immigration, Refugees and Citizenship Canada (IRCC) if any information on this form changes before the minor takes the Oath of Citizenship. I understand the content of this form. I declare that the information provided is true, correct and complete, and that the photographs enclosed are a true likeness of the minor. I understand that if I or someone on my behalf, makes a false representation, commits fraud, conceals material circumstances relevant to the minor's application, the minor could be prohibited from becoming a citizen and reapplying for citizenship for 5 years, the minor's citizenship could be revoked and I could be charged with an offence as provided for under the Citizenship Act or the Criminal Code. Notice: IRCC may verify the authenticity and accuracy of any documents you have provided in support of the minor's application for a grant of citizenship with the body that issued the documents. I have indicated in Section 8 of this form whether the prohibitions apply to the minor. IMPORTANT NOTE: Remember to make sure that the minor is eligible to apply for citizenship on the day BEFORE you sign this application. (you must sign inside the white box in black ink only)

City

►Date

(YYYY-MM-DD)

Minor's signature

City

►Date

(YYYY-MM-DD)

A minor (14 years of age and older) must also sign this form

I cannot obtain the signature of a parent or person empowered to act on my behalf therefore I am seeking a waiver under subparagraph 5(3)(b)(v) of the Citizenship Act to submit my application per paragraph 5(1.05) of the Act.

Protected Information Personal Information Bank CIC PPU 050

The information you provide on this form is collected under the authority of the Citizenship Act to determine whether your citizenship application may be approved. It will be stored in the Personal Information Bank (CIC PPU 050 entitled Application and Assessment for Canadian Citizenship). The information may be shared with other Canadian government institutions such as the Canada Border Services Agency (CBSA), the Royal Canadian Mounted Police (RCMP), the Canadian Security Intelligence Service (CSIS), and foreign governments in accordance with the Citizenship Regulations or subsection 8(2) of the Privacy Act. Information may also be disclosed to foreign governments, law enforcement bodies and detaining authorities with respect to the administration and enforcement of citizenship legislation where such sharing of information may not put the individual and/or their family at risk. Information may also be systematically validated by other Canadian government institutions under the terms of an agreement or arrangement for the purposes of validating status and identity to administer their programs. In accordance with the Privacy Act and the Access to Information Act, individuals have a right to protection of, access to and correction of their personal information. Details on these matters are available at the InfoSource Website at http://infosource.gc.ca. InfoSource is also available at public libraries across Canada.

Next Steps: 1. Pay the application fee online ($100 per minor applicant under 18 years of age) and print receipt 2. Complete the document checklist, to submit with the application 3. If a family is applying together, include all applications in the one envelope 4. Print and send your application and the documents to:

Case Processing Centre-Sydney 49 Dorchester Street Sydney, Nova Scotia B1P 5Z2

Courier Address

Case Processing Centre-Sydney P.O. Box 7000 SYDNEY, NS B1P 6V6

Regular Mail