PR Card

Applicant Situation

Full name as shown on your Record of landing, Confirmation of permanent Resident or last PR card*:Current name if is different from the aboveChoose the option that represent your currently situation*:Choose the option that applies for you*:
UCI number*:Language of correspondence*:Date you became PR*:Place you became PR*:Province you became PR*:Gender*:Date of birth*:Country or territory of birth*:

Applicant Situation

Marital status and relationship status*:Country of citizenship*:If you have more than one territory of country of citizenship list allPrimary phone number*Type*Number*ExtensionEmail*

Immigration History

Have you ever been issued a removal order from Canada?*Has an immigration officer ever issued you an inadmissibility report?*Have you ever lost your status as a PR of Canada?*Have you ever summited an appeal to the Immigration Appeal Division of Refugee Board against a decision on the resident obligation?*Have you ever issued any of the following?

Immigration History II

Address History

List your address history for the past 5 years or if you became PR less than 5 years ago, your address history since you became PR. List it from the most recent tо the oldest:1.- From*To*Street number and name*City or town*Province / State / District*Country or Territory*

Immigration History III

If the question does not apply to your process, please write “N/A”.

2.- FromToStreet number and nameCity or townProvince / State / DistrictCountry or Territory3.- FromToStreet number and nameCity or townProvince / State / DistrictCountry or Territory

Immigration History IV

If the question does not apply to your process, please write “N/A”.

4.- From*To*Street number and name*City or town*Province / State / District*Country or Territory*5.- FromToStreet number and nameCity or townProvince / State / DistrictCountry or Territory

Immigration History V

Work and education History

List your work and educational history for the past 5 years or if you became PR less than 5 years ago, your work and educational history since becoming PR. If you have no working or study, please complete the activity column whichever activity applies for you.

1. From* ______________________

To*

Name of employer or institution*

Activity*

City or town*

Province / State / District*

Country or Territory

Immigration History VI

If the question does not apply to your process, please write “N/A”.

2. From ______________________

To

Name of employer or institution

Activity

City or town

Province / State / District

Country or Territory

3. From ______________________

To

Name of employer or institution*

Activity

City or town

Province / State / District

Country or Territory

Immigration History VII

4. From* ______________________

To*

Name of employer or institution*

Activity*

City or town*

Province / State / District*

Country or Territory

5. From ______________________

To

Name of employer or institution

Activity

City or town

Province / State / District

Country or Territory

Residency Obligation

Have you travelled or lived outside of Canada in the 5 past years?*

Have you ever been employed on a full-time basis by a Canadian business outside of Canada or in the federal public administration or public service of a province, while you were absent from Canada?*

Have you ever been accompanying a Canadian citizen who is your spouse, common-law partner, or child, or parent, while you were absent from Canada?*

Have you ever accompanied a PR who is your spouse, common-law partner, or in the case of a child or parent, and who is employed on a full-time basis by a Canadian business outside of Canada or in the federal public administration or public service of a province, while you were absent from Canada?*

Residency Obligation II

Time you spent outside of Canada

You must provide all your absents from Canada on the past 5 years or since you became PR if less 5 years ago. List all your absences from the most resent to the oldest.

1. From

To

Location during the absence

Days

Reason of your absence

If other, add the reason:

Residency Obligation III

If the question does not apply to your process, please write “N/A”.

2. From

To

Location during the absence

Days

Reason of your absence

If other, add the reason:

Residency Obligation IV

If the question does not apply to your process, please write “N/A”.

3. From

To

Location during the absence

Days

Reason of your absence

If other, add the reason:

Residency Obligation V

If the question does not apply to your process, please write “N/A”.

4. From

To

Location during the absence

Days

Reason of your absence

If other, add the reason:

Residency Obligation VI

If the question does not apply to your process, please write “N/A”.

5. From

To

Location during the absence

Days

Reason of your absence

If other, add the reason:

Residency Obligation VII

If the question does not apply to your process, please write “N/A”.

6. From

To

Location during the absence

Days

Reason of your absence

If other, add the reason:

Stolen Lost Card

NOTE

Complete this section only if you are applying for a lost, stolen, damage or never recived you PR card

PR card number

Day of issued

PR card was

Date (if you know)

Country or territory

Stolen Lost Card II

Provide many details as possible*

I made the follow efforts to located this document

Should I ever regain possession of my original PR card, I promise to destroy it immediately

Consent And Disclaimer

History of entries into Canada and income tax information and filing history*

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 my history of entries into Canada to Immigration, Refugees and Citizenship Canada (IRCC) in order to assist IRCC in determining my eligibility for a PR card or a PRTD. I also hereby authorize IRCC to collect the history of my entries into Canada from the CBSA and to collect my social insurance number for the purpose of requesting that the Canada Revenue Agency (CRA) disclose my income tax information and residency information for any taxation years required to assist in determining whether I meet the residency obligation as set out in section 28 of the Immigration and Refugee Protection Act.

Consent to disclosure my income tax information and residency information (CRA)?*

Social Insurance Number

Consent

I certify that the information given on this form and in any documents included is correct, complete and accurate*
I understand that any false statements or concealments of a material fact may be grounds for my prosecution or removal*
I understand the foregoing statements, having asked for and obtained an explanation on every point that was not clear to me*
I further understand that the information provided by me may be verified and hereby consent to such verification activities*
I acknowledge that I have verified my absences one more time as my absences may have changed from when I initiated the IMM5444 form*
I certify that the information contained in this document is complete, accurate and factual. I also realize that once this document has been completed and signed that it will form part of my Immigration Record and will be used to verify my family details on future applications*
I accept that Rita Khalfon Immigration Consulting makes use of my information for my immigration application process*

Pr Card

Applicant Situation

Applicant Situation

Immigration History

Immigration History II

Immigration History III

Immigration History IV

Immigration History V

Immigration History VI

Immigration History VII

Residency Obligation

Residency Obligation II

Residency Obligation III

Residency Obligation IV

Residency Obligation V

Residency Obligation VI

Residency Obligation VII

Stolen Lost Card

Stolen Lost Card II

Consent And Disclaimer

Consent