IDJADI Immigration Consultancy موسسه مهاجرتی ایجادی

IMM 5708 — Client Information Form

Application to Change Conditions, Extend my Stay or Remain in Canada as a Visitor or Temporary Resident Permit Holder

For preparation of the official IRCC IMM 5708. This online questionnaire is not the prescribed IRCC form and is not submitted directly to IRCC.

APPLICATION DETAILS

1. UCI

2. Preferred language of service

3. I am applying for one or more of the following

An extension of my status as a visitor
An initial or subsequent Temporary Resident Permit
Restoration of my status as a visitor

PERSONAL DETAILS

1(a). Family name (surname)

1(b). Given name(s)

2(a). Have you ever used any other name?

3. Gender

4. Date of birth

If your complete date of birth is unknown, enter the known parts and use * for unknown year/month/day.

5(a). City or town of birth

5(b). Country or territory of birth

6. Country or territory of citizenship

7(a). Current immigration status in Canada

7(c). Status — From

7(d). Status — To

8(a). In the past 5 years, have you lived in a country other than your country of citizenship or current country of residence for more than 6 months?

9(a). Current marital status

10(a). Have you previously been married or in a common-law relationship?

LANGUAGE

1(a). First (native) language

1(b). If your native language is not English or French, which language do you use most?

2. Language of communication

3. Have you taken a test from a designated testing agency to assess your English or French proficiency?

PASSPORT

1. Passport or travel document number

2. Country or territory of issue

3. Issue date

4. Expiry date

5. Are you using a passport issued by the Ministry of Foreign Affairs in Taiwan that shows your personal identification number?

6. Are you using a National Israeli passport?

NATIONAL IDENTITY DOCUMENT

1. Do you have a national identity document?

U.S. PERMANENT RESIDENT CARD

1. Are you a lawful permanent resident of the United States with a valid alien registration card (green card)?

CONTACT INFORMATION

Mailing address — use the address where IRCC correspondence should be sent.

1(a). P.O. Box

1(b). Apartment / Unit

1(c). Street number

1(d). Street name

1(e). City / Town

1(f). Country or territory

1(g). Province / State

1(h). Postal / ZIP code

2(a). Is your residential address the same as your mailing address?

3(a). Primary telephone location

Canada
United States
Other

3(b). Primary telephone type

3(c). Primary telephone number

3(d). Extension

4(a). Additional telephone location

Canada
United States
Other

4(b). Additional telephone type

4(c). Additional telephone number

4(d). Extension

5(a). Fax location

Canada / United States
Other

5(b). Fax number

6. Email address

COMING INTO CANADA

1(a). Date you first entered Canada

1(b). Place you first entered Canada

2(a). Purpose of your original visit

3(a). Date of your most recent entry to Canada

3(b). Place of your most recent entry to Canada

4. Document number of your most recent Visitor Record, study permit or work permit

DETAILS OF VISIT TO CANADA

1(a). Reason you want to extend your stay

Super Visa option applies only to those who entered Canada with a Super Visa.

2(a). I plan to stay in Canada — From

2(b). I plan to stay in Canada — To

3. Funds available for my stay in Canada (CAD)

4. Person(s) or institution(s) I will visit in Canada

Name of person or institution

Relationship

Address in Canada

EDUCATION

Do you have any post-secondary education, including university, college or apprenticeship training?

EMPLOYMENT / WORK / OCCUPATION

Provide details of your employment/activity for the last 10 years. If retired, provide the 10 years before retirement.

1. Current activity — From

1. Current activity — To / Present

1. Activity / Occupation

1. Company / Employer / Facility

1. City / Town

territory English you

1. Country or territory

1. Province / State

2. Previous Activity / Occupation — past 10 years

From

Activity / Occupation

Company / Employer / Facility

City / Town

Country or territory

Province / State

BACKGROUND INFORMATION

All questions in this section must be answered.

1(a). In the past 2 years, have you or a family member had tuberculosis of the lungs or been in close contact with a person with tuberculosis?

1(b). Do you have a physical or mental condition that would require social or health services, other than medication, during your stay in Canada?

2(a). Have you ever remained beyond the validity of your status, attended school without authorization, or worked without authorization in Canada?

2(b). Have you ever been refused a visa or permit, denied entry, or ordered to leave Canada or any other country or territory?

2(c). Have you previously applied to enter or remain in Canada?

3(a). Have you ever committed, been arrested for, been charged with, or been convicted of any criminal offence in any country or territory?

4(a). Have you ever served in any military, militia, civil defence unit, security organization or police force, including non-obligatory national service, reserve or voluntary units?

5. Have you ever been a member of or associated with any political party, group or organization which engaged in or advocated violence as a means to achieving a political or religious objective, or which has been associated with criminal activity?

6. Have you ever witnessed or participated in the ill treatment of prisoners or civilians, looting, or desecration of religious buildings?

Review all answers before submitting this client intake.

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5708

IMM 5708 — Client Information Form

8(b). Country residence details

10(b-f). Previous spouse/common-law relationship details

4. Person(s) or institution(s) I will visit in Canada

2. Previous Activity / Occupation — past 10 years