This form must be completed by the student who is a refugee or protected person or who has obtained his or her permanent residence or Canadian citizenship but whose parents or spouse never lived in Canada before January 1, 2021.
This form will not be considered valid unless it has been countersigned by a Commissioner for Oaths.
This form does not apply to Canadian-born citizens.
- Check only one box in Section 2.
- The address needed in Section 2 is the address outside of Canada.
Once you print and fill out the form, sign it yourself and have it signed by a Commissioner for Oaths, then scan it. Use your online file to upload the completed form.
Other way to submit your document
If you are unable to submit this form digitally you can mail it to us. Print the form, fill it out, sign it yourself, have it signed by a Commissioner for Oaths and mail it to the address shown on the form itself.