Enter your full family name (surname or last name) exactly as it is shown on your passport, travel or identity document. For more information, please contact OMC. You will not receive a reply. From the list, select the type of telephone: If you have a second telephone number, enter it here, including the country code, area/regional codes, etc. If you do not sign and date, the application will be returned to you. All communication with Express Entry candidates and applicants is conducted through their MyCIC account. Place the barcode page on top of your package. From the list, select your highest level of education. Get help to open an application form or to fill one out in the Help Centre. Use our detailed instructions to fill out and eSign your documents online. Under the change, spousal sponsorship applicants will now be asked to submit their Schedule A - Background/Declaration (IMM 5669) form and police certificates as part of their initial paper application package, instead of later in the application process, as was previously required. If there is not enough space to provide all the necessary information, use an extra sheet of paper. This application form uses special features and you cant view it using your Internet browser. Get ready to apply You must now apply online As of September 23, 2022, you must now apply online for this program. It also includes assistance for items such as: Food Shelter Clothing Fuel Utilities Household supplies Personal requirements and, Select Yes or No to tell us whether they have taken a test from a designated testing agency to assess their proficiency in English or French. Convince the immigration officer that you will not overstay in the country and will leave Canada on time. Amgad @Amgad18466478 15h 15 hours ago. If you do not know your complete date of birth, please use an * (asterisk) to fill in the spaces for the unknown year, month or day. How to Edit and fill out Imm 5669 2018 Online. List all trips that the dependent child has taken outside their country of origin or of residence in the last ten years (or since their 18th birthday if this was less than ten years ago). For refugee claimants in Canada only: select Canada whether your dependant has been lawfully admitted or not. List all trips your spouse or common-law partner has taken outside their country of origin or of residence in the last ten years (or since their 18th birthday if this was less than ten years ago). #imm5669e #schedulea #irccHello,In this video, I have explained the step by step details of filling up the new schedule A background declaration form. This includes: You must answer all questions. under Activity, enter your occupation or job title. Make sure there is no space between each number or letter. Forms that are available outside the MyCIC system include the following: Note: In exceptional circumstances, persons with disabilities who are unable to complete an online Express Entry profile or application for permanent residence(APR) but are able to complete these forms in paper format may be provided these forms in paper format. Select the box to tell us if you have lived in any country other than your country of citizenship or your current country of residence for more than 6 months in the past 5 years. Express Entry candidates fill out a dynamic form in their MyCIC account to create their profile. If you dont have one or cant obtain one, you must select the No box. Important information: Please ensure that you do not leave any gaps in time. The principal applicant must answer the following questions. For refugee claimants in Canada only: Enter the total number of family members included in your application for refugee protection who are with you in Canada. If you wish to have a representative who can conduct business on your behalf, you must provide their address in this section and on the Use of a Representative (IMM 5476) form. From the list, select your dependants current marital status: Select the box to tell us if your dependant has previously been married or in a common-law relationship. For example, if the day and month of your date of birth is unknown you could enter 1964/*/*. You must select the country . Select the box to tell us if your residential address (where you live) is the same as your mailing address. You also have the option of saving your form and completing it later. You can fill it out and save it using a computer. Do not leave gaps in time. Express Entry is an entirely electronic application management system. Do not use P.O. If you selected Yes, provide your national identity document number exactly as shown on the identity document. your spouse or common-law partner (whether accompanying you to Canada or not). Only bank drafts or From the list, select the name of your dependants current country of residence. Select the box to tell us if your second telephone number is from Canada or the US or Other (any other country). form IMM 5669 . The name of your current country of residence. Provide the details of your military or paramilitary service for each of the countries whose armed forces you served in. To include everyone in your application, you must complete the following form for each additional family member: You must list all family members in your application for permanent residence, whether they are accompanying you to Canada or not. If you were or still are a member of an association or organizing, enter the names here. Place the barcode page(s) on the top of your application (forms and supporting documents) when you submit it. If you are a citizen of more than one country, select your other country of citizenship. Having trouble downloading the form? Select the box to tell us if your dependant has lived in any country other than their country of citizenship or their current country of residence for more than 6 months in the past 5 years. Note: Completing the form electronically is easier and reduces the risk of errors that can slow down the application process. It is the number on your house or apartment building. Enter the date their national identity document will expire. Once completed you can sign your fillable form or send for signing. Your mailing address (include city and country) 15. Enter the date your passport or travel document will expire. From the list, select your first (native) language. For this trip, select Yes or No to tell us if you are using a passport issued by the Ministry of Foreign Affairs in Taiwan that shows your personal identification number. Note: If you are a parent of a child to be adopted in Canada who is not yet identified, indicate Unknown.. Enter the date of your last entry to Canada, if applicable. To view the PDF form, you need to: (Dont know what these mean? any of your children who are in the custody of an ex-spouse, former common-law partner or other guardian. Note: If you are less than 18 years of age, your form must be signed by one of your parents or a legal guardian. Do not use initials. If you selected Yes, provide their national identity document number exactly as shown on the document. You can find additional information on the EOI points grid in Appendix A. Once the application is completed, click on the Validate button located at the top or bottom of the form. Social Assistance Social assistance refers to any benefit (including money, goods or services), provided to or on behalf of a person by a province under a program of social assistance. 3. IMM 5669 - Schedule A Background/Declaration To be completed and signed by the Principal Applicant and spouse/common-law . As well we have a guide on how to go about immigration from Israel to Canada as a student. A last page with barcodes and a signature line will automatically be created. If you need more space, attach a separate sheet of paper. the instruction guide for more information. Schedule A- Background / Declaration (IMM 5669) completed and signed by . Sponsoring your spouse, partner or dependent child Sponsoring your spouse, partner or dependent child Get help to open an application form or to fill one out in the Help Centre. Authority to disclose personal information If you were outside your country of nationality, enter your status of the country you were in. For example: Arabic, Cyrillic, Chinese, Farsi, Korean, Japanese characters or Chinese commercial/telegraphic code. Step 1: Read the guide and get your application package. Select the box to tell us if your residential address (where you live) is the same as your mailing address. Note: If you are a parent of a child to be adopted in Canada who is not yet identified, select Other.. Enter any government positions you have held in the past such as: Enter NONE in the box if you have not been a member of an association or organization. My immigration or citizenship application, Super visa (for parents and grandparents), Change conditions or extend your stay as a visitor, Stay in Canada as a temporary resident permit (TRP) holder, Temporary resident permit (TRP) for victims of human trafficking, Correct an error on your temporary resident document, Verification of Status (VOS) or replacement of an immigration document, Rehabilitation for Persons who are Inadmissible to Canada because of Past Criminal Activity, Study permit application from within Canada, Study permit application from outside of Canada, Extend or change the conditions on your study permit, Visitor visa for students from within Canada, Study and work as an international student, Work permit under the Atlantic Immigration Pilot, Work Permit for victims of human trafficking, Extend or change the conditions on your work permit, Create an International Experience Canada (IEC) profile, Apply for an IEC work permit (after being invited to apply, Visitor visas for workers from within Canada, Application for Permanent Residence under the updated temporary Public Policy for Extended Families of Former Afghan Interpreters, Home Child Care Provider Pilot and Home Support Worker Pilot, Pathway to permanent residence: In-Canada families of Canadian victims of recent air disasters, Provincial Nominees - Apply through Express Entry, Permanent residence for temporary resident permit holders, Right of Permanent Residence Fee loan application, Temporary Public Policy: Out-of-status construction workers in the Greater Toronto Area (GTA), Temporary resident to permanent resident pathway, Health-care workers permanent residence pathway, Correct an error on your Record of Landing or your Confirmation of Permanent Residence, Adopted children and other relatives - Application package for sponsor, Adopted children and other relatives - Application package for sponsored person, Application guide for the Canadian Refugee Protection Portal (CRPP), Application for Interim Federal Health Program (IFHP) Coverage, Convention Refugees Abroad and Humanitarian Protected Persons Abroad, Protected Persons and Convention Refugees in Canada, Community Sponsors, Groups of Five and Sponsorship Agreement Holders and Constituent Groups, Request to Process Following Family Members under the One-Year Window of Opportunity Provisions, Sponsorship Agreement Holder: Organizational Assessment Guide, Humanitarian and Compassionate Considerations, Permanent residence pathways for Hong Kong residents, Visitors - change conditions or extend your stay, Students - change conditions or extend your stay, Workers - change conditions or extend your stay, Visitor visas for workers and students in Canada, Stay in Canada as a Temporary Resident Permit Holder, Temporary Resident Permit (TRP) and Work Permit for victims of human trafficking, Permanent Resident Card (PR Card) (initial, renewal or replacement), Request to reissue a permanent resident card, Solemn Declaration Concerning a Lost, Stolen, Destroyed or Never-Received Permanent Resident Card (PR Card), Application to Amend the Record of Landing, Confirmation of Permanent Resident or Valid Temporary Resident Documents, Voluntary Renunciation of Permanent Resident Status, Stateless person born to a Canadian parent, Apply for a citizenship certificate (or replacement), Solemn Declaration Concerning a Citizenship Certificate That Was Lost, Stolen, Destroyed or Never Received, Renounce Canadian Citizenship R7.1 (for certain persons who acquired citizenship under amendments to the Citizenship Act in 2009 or 2015), Resume Canadian Citizenship Canadian Armed Forces, Access to information and personal information request, Consent for an access to information and personal information request, Application for a Citizenship Certificate, Application for Canadian Citizenship Adults, Application for Canadian Citizenship Minors, Document Checklist: Application for Canadian Citizenship under Subsection 5(1) Adults (18 years of age and older), Document Checklist: Application for Canadian Citizenship under Paragraph 5(2) Minors (under 18 years of age), Confirmation of Canadian Citizenship of the Adoptive Parent(s), Document Checklist: Application for a Citizenship Certificate (Proof of Citizenship), Application for a Search of Citizenship Records, Document Checklist: Application for Canadian Citizenship Canadian Armed Forces under Subsection 5(1.2) or 5(1.3), Application to Resume Canadian Citizenship, Application to Renounce Canadian Citizenship, Document Checklist: Application to Renounce Canadian Citizenship under Subsection 9(1), Application for Canadian citizenship Minors (under 18 years of age) applying under Subsection 5(1), Statutory Declaration of Common-law Union Citizenship, Canadian Citizenship Certificate Preparation Form, Document Checklist: Adoption Part 1 Confirmation of Canadian Citizenship of the Adoptive Parent(s), Document Checklist: Adoption Part 2 Adoptees Application, Application to Renounce Canadian Citizenship R7.1 (for certain persons who acquired citizenship under amendments to the Citizenship Act in 2009 or 2015), Application for Grant of Citizenship for Stateless Persons Born to a Canadian Parent (Subsection 5(5)), Document Checklist: Application for Grant of Citizenship for Stateless Persons Born to a Canadian Parent (Subsection 5(5)), Document Checklist: Application to Renounce Canadian Citizenship (For certain persons who acquired citizenship on April 17, 2009 R7.1), Application for Canadian citizenship Canadian Armed Forces under Subsection 5(1.2) or 5(1.3), Application to Resume Canadian Citizenship Canadian Armed Forces, Document Checklist: Application for Canadian citizenship under subsection 5(1) Minors (under 18 years of age), Document Checklist: Sponsorship Agreement Holders (SAH), Statutory Declaration for the Purpose of Entry Into Canada for Extended Family Members COVID-19 Emergency Orders in Council Under the, Schedule 4A: Provincial Business Nominees, Schedule 5: Economic Classes Declaration of Intent to Reside in Quebec, Schedule 6: Business Immigrants Investors and Entrepreneurs Declaration of Intent to Reside in Quebec, Schedule 6A: Business Immigrants Self-Employed Persons, Schedule 9: Sponsorship Declaration of Intent to Reside in Quebec, Schedule 12: Additional Information Refugee Claimants inside Canada, Schedule 13: Business Immigration Programs Start Up Business Class, Schedule 14: Protected Persons and Convention Refugees, Statutory Declaration for the Parent of a Minor for the Purposes of Entry into Canada for Extended Family Members COVID-19 Emergency Orders in Council Under the, Letter of explanation Open work permit for vulnerable workers, Application to Become a Sponsorship Agreement Holder, Schedule 1: Temporary Public Policy to further facilitate access to permanent resident status for out-of-status construction workers in the Greater Toronto Area (GTA), Offer of Employment to a Foreign National: Agri-Food Pilot, Document Checklist: Temporary Public Policy to further facilitate access to permanent resident status for out-of-status construction workers in the Greater Toronto Area (GTA), Document Checklist: In-Canada families of Canadian victims of recent air disasters, Schedule 3 Temporary Resident to Permanent Resident Pathway: Streams A & B and International Graduates, Document Checklist: Permanent residence pathways for Hong Kong residents (Stream A and Stream B), Schedule 7A Permanent residence pathways for Hong Kong residents: Stream A In-Canada graduates, Schedule 7B Permanent residence pathways for Hong Kong residents: Stream B Canadian work experience, Document Checklist: Economic Mobility Pathways Pilot, Schedule 20: Economic Mobility Pathways Pilot, Document Checklist: Application for Permanent Residence under the updated temporary Public Policy for Extended Families of Former Afghan Interpreters, Schedule 1: Application for Permanent Residence under the updated temporary Public Policy for Extended Families of Former Afghan Interpreters, Statutory Declaration to Confirm the Relationship to Extended Family Members, Document Checklist: Atlantic Immigration Program, Undertaking for an Application for a Work Permit Exempted from a Labour Market Impact Assessment (LMIA) as part of the Atlantic Immigration Program (AIP), Offer of Employment to a Foreign National: Atlantic Immigration Program, Document Checklist for a Work Permit for Candidates under the Atlantic Immigration Program (Outside Canada applicant), Document Checklist for a Work Permit for Candidates under the Atlantic Immigration Program (In Canada applicant), 2022 Sponsorship Agreement Holder (SAH) Organizational Assessment, Document Checklist: for Sponsorship Agreement Holder (SAH) Organizational Assessment, Document Checklist: Application Forms for Outside-of-Canada Families of Canadian Victims of Air Disasters, Statutory Declaration for Extended Family Members Outside Canada of a Canadian Victim of an Air Disaster that may apply for a Permanent Residence Visa, Declaration Authorization for representative to submit a refugee claim through the IRCC Portal, Economic Mobility Pathways Pilot (EMPP) Pre-Arrival Facilitations Form, Document Checklist: Application Forms for Health-Care Workers Permanent Residence Pathway (COVID-19 pandemic), Schedule 1: Health-care Workers Permanent Residence Pathway, Application for a Study Permit Made Outside of Canada, Application for a Work Permit Made Outside of Canada, Undertaking/Application for a Joint Assistance Sponsorship, Application to Sponsor, Sponsorship Agreement and Undertaking, Verification of Status (VOS) or Replacement of an Immigration Document, Application for a Temporary Resident Visa, Schedule 1: Application for a Temporary Resident Visa, Document Checklist: Humanitarian & Compassionate Considerations, Supplementary Information: Humanitarian and Compassionate Considerations, Document Checklist: Protected Person Permanent Residence, CanadaUnited StatesMexico Agreement Application for trader/investor status (work permit), Right of Permanent Residence Fee Loan Application, Sponsorship Undertaking Sponsorship Agreement Holders (SAH), Additional Family Information Form Permanent Residence, Statutory Declaration of Common-Law Union Temporary and Permanent Residence, Settlement Plan Sponsorship Agreement Holder or Constituent Group, Application for a Permanent Resident Card or Permanent Resident Travel Document, Solemn Declaration Concerning a Permanent Resident Card That Was Lost, Stolen, Destroyed or Never Received, Document Checklist: Atlantic High-Skilled Program, Document Checklist: Atlantic Intermediate-Skilled Program, Authority to Release Personal Information to a Designated Individual, Sponsorship Evaluation Form Dependent Children, Document Checklist: Temporary Resident Visa (Visitor Visa) outside of Canada, Document Checklist: Work Permit (Applied outside Canada), Settlement Plan: Joint Assistance Sponsorship, Document Checklist: Joint Assistance Sponsorship, Document Checklist: Atlantic International Graduate Program, Atlantic Immigration Program Declaration Form, Request for a Joint Assistance Sponsorship Refugee Profile, Settlement Plan and Financial Assessment: Community Sponsors, Statutory Declaration of Severance of a Common-Law Union, Document Checklist: Temporary Resident Permit Holders, Request to Reissue a Permanent Resident Card, Relationship Information And Sponsorship Evaluation Form, Document Checklist: Spousal Sponsorship (Including Dependent Children), Document Checklist: Sponsoring a Dependent Child, Document Checklist: Worker (in Canada Applicant), Document Checklist: Temporary Resident Permit, Document Checklist: Temporary Resident Visa (Visitor Visa) in Canada Applicant, Access to Information and Personal Information Request, Application for the Interim Federal Health Program (IFHP) Coverage, Request for Processing Family Members under the One-Year Window of Opportunity Provisions, Humanitarian and Compassionate Considerations under the February 4, 2016 Temporary Public Policy for Nationals of Haiti and Zimbabwe, Document Checklist: Students Applying for a Work Permit, Document Checklist: Sponsoring a Common-Law Partner (Including Dependent Children), Declaration from Non-accompanying Parent/Guardian for Minors Immigrating to Canada, Request to Add a Family Member to a Privately Sponsored Refugee Application, Document Checklist: Sponsoring a Conjugal Partner (Including Dependent Children), Live-in Caregiver: Employer Declaration of Hours Worked, Document Checklist: Application for a Permanent Resident Card or Permanent Resident Travel Document, Family Information Form Visitors, Students and Workers, Document Checklist: Atlantic Immigration Pilot Program Work permit (in Canada applicant), Document Checklist: Atlantic Immigration Pilot Program Work permit (applied outside Canada), Undertaking for an Application for a Work Permit Exempted from a Labour Market Impact Assessment (LMIA) as part of the AIP, Sponsorship Undertaking and Settlement Plan: Community Sponsor (CS), Schedule A: Sponsorship Background/Declaration Form To be used only when applying for refugee protection within Canada (Guide 5746), Schedule A: Background / Declaration Form, Sponsorship Undertaking and Settlement Plan: Groups of Five, Request for an opinion on Work Permit or LMIA Exemption, Document Checklist: Provincial Nominee Program and Quebec Skilled Workers, Application to Change Conditions, Extend my Stay or Remain in Canada as a Visitor or Temporary Resident Permit Holder, Application to Change Conditions, Extend my Stay or Remain in Canada as a Student, Application to Change Conditions, Extend my Stay or Remain in Canada as a Worker, Document Checklist: Temporary Resident Visa (Visitor Visa) Applicants in Canada, Document Checklist: Federal and Quebec Selected Business Class Applicants, Return of Processing Fee, Right of Permanent Residence Fee or Right of Landing Fee, Consent for an Access to Information and Personal Information Request, Document Checklist: Applying for Refugee Protection within Canada, Income Sources for the Sponsorship of Parents and Grandparents, Document Checklist: Start up Business Class, Start-up business class commitment certificate: letter of support, Start-up business class commitment certificate for designated entities, Financial Evaluation for Parents and Grandparents Sponsorship, Document Checklist: Sponsoring Parents and Grandparents, Return of Application Fees for the Federal Immigrant Investor Program (IIP) and Entrepreneur Program (EN), Application to Voluntarily Renounce Permanent Resident Status, Document Checklist: Voluntary Renunciation of Permanent Resident Status, Document Checklist: Quebec Selected Self-employed and Federal Self-employed Persons, Rural and Northern Immigration Pilot Community Interest Form, Schedule 19b: Home Child Care Provider or Home Support Worker (Work Experience), Schedule 1: Rural and Northern Immigration Pilot, Document Checklist: Applicants in the USA applying for Rehabilitation or Temporary Resident Permits (TRP), Document Checklist: Applicants in the USA applying for an Authorization to Return to Canada (ARC), Appointment of Representative(s) in Expected Community of Settlement Form, International Mobility Program Employer Compliance Voluntary Disclosure Form, Important Medical Information: Syphilis Treatment Form, Document Checklist: Home Child Care Provider or Home Support Worker, Schedule 19a: Home Child Care Provider or Home Support Worker (Language and Education), Offer of Employment: Home Child Care Provider or Home Support Worker, Offer of Employment to a foreign national: Rural and Immigration Pilot, Document Checklist: Rural and Northern Immigration Pilot, Request form for a Change of Sex or Gender Identifier, Confirmation of Eligibility for a Reclaimed Name Change Gratis Replacement Document Under Call to Action 17, Statutory Declaration to Reclaim an Indigenous Name on Canadian Citizenship Certificates or Permanent Resident Cards, Application for Permanent Residence under the updated temporary Public Policy for extended family members of Afghan Interpreters, Access to information and privacy request, To immigrate as a refugee or protected person, For humanitarian and compassionate considerations, Proof of citizenship (citizenship certificate). 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