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Family Information Form for Canada

This document is an application for a visitor visa to Canada that collects family information. It requests the applicant provide details about themselves such as name, date of birth, country of birth, marital status, and present address. It also asks the applicant to provide information about family members like spouse/partner, mother, father, children, brothers, and sisters including their names, relationships, dates of birth, countries of birth, addresses, and whether they will accompany the applicant to Canada. The applicant must certify that the information provided is complete, accurate and will form their immigration record to be used for future applications.

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166 views2 pages

Family Information Form for Canada

This document is an application for a visitor visa to Canada that collects family information. It requests the applicant provide details about themselves such as name, date of birth, country of birth, marital status, and present address. It also asks the applicant to provide information about family members like spouse/partner, mother, father, children, brothers, and sisters including their names, relationships, dates of birth, countries of birth, addresses, and whether they will accompany the applicant to Canada. The applicant must certify that the information provided is complete, accurate and will form their immigration record to be used for future applications.

Uploaded by

AjayBravo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Citizenship and Citoyenneté et PROTECTED WHEN COMPLETED - B

Immigration Canada Immigration Canada


PAGE 1 OF 2

FAMILY INFORMATION
Type of application: ✔ Visitor Worker Student Other

Complete ALL names in English and in your native language (for example, Arabic, Cyrillic, Chinese, Chinese commercial/telegraphic code, Korean, or Japanese
characters). Include ALL family members even if they are not accompanying you. If you need more space for any section, print out an additional page containing
the appropriate section, complete and submit it with your application.
BEFORE YOU START, READ THE INSTRUCTION GUIDE, TYPE OR PRINT IN BLACK INK.
SECTION A
Date of birth Present address Will
Relationship Y M D (If deceased give city and date) accompany
Full name Marital status
SEE NOTE 1 Country you to Canada?
Present occupation
of birth YES NO

1997 10 14
ANGEL BHERT SALINAS BRAVO
APPLICANT
PHILIPPINES

SPOUSE OR
COMMON-LAW
PARTNER INDONESIA

IRENE SALINAS MACARANAS 1957 10 29


MOTHER ✔
PHILIPPINES

VIRGILIO SALINAS BRAVO


FATHER
PHILIPPINES

NOTE 1: If no spouse or common-law partner is listed in Section A, read and sign below.
Year Month Day

I certify that I do not have a spouse or a common-law partner. Signature: Date:

SECTION B CHILDREN (Include ALL sons and daughters, including ALL adopted and step-children, regardless of age or place of residence)
Date of birth Present address Will
Relationship Y M D (If deceased give city and date) accompany
Full name Marital status
SEE NOTE 2 Country you to Canada?
Present occupation
of birth YES NO

NOTE 2: If no children are listed in Section B, read and sign below.


Year Month Day

I certify that I do not have any children, either natural or adopted. Signature: Date:

IMM 5645 (09-2010) E (DISPONIBLE EN FRANÇAIS - IMM 5645 F)


PAGE 2 OF 2
SECTION C BROTHERS AND SISTERS (Include ALL brothers and sisters, ALL half-brother and sister and stepbrother and sister.)
Date of birth Present address Will
Y M D (If deceased give city and date) accompany
Full name Relationship Marital status
Country you to Canada?
Present occupation
of birth YES NO

SECTION D CERTIFICATION
I certify that the information contained on 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.

Year Month Day

Signature: Date:

The information you provide on this form is collected under the authority of the Immigration and Refugee Protection Act to determine if you may be admitted to Canada as a temporary
resident. It will be stored in Personal Information Bank CIC PPU 055, Visitor Case File. It is protected and accessible under the Privacy Act and the Access to Information Act.

IMM 5645 (09-2010) E

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