Transcription of IMM 5654 E : Undertaking for an Application for a Work ...
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PAGE 1 OF 2 IMM 5654 (03-2017) EPROTECTED WHEN COMPLETED - B(DISPONIBLE EN FRAN AIS - IMM 5654 F) Undertaking FOR AN Application FOR A WORK PERMIT EXEMPTED FROM A LABOUR MARKET IMPACT ASSESSMENT (LMIA) AS PART OF THE atlantic immigration PILOT (AIP)A AIP CANDIDATEP rincipal applicant - Family name (surname)Given name(s)FOR IRCC USE ONLYUCI of birth (YYYY-MM-DD)City and country of birthFamily statusCountry of citizenshipB AIP PROGRAMP rovince of destinationAIP programAtlantic High-Skilled ProgramAtlantic Intermediate-Skilled ProgramAtlantic International Graduate ProgramC EMPLOYER INFORMATIONB usiness operating nameBusiness mailing address:Street and numberApt. / UnitCityProvincePostal codeTelephone numberCell numberEmail addressCompany representative:Family name (surname)Given name(s)TitlePAGE 2 OF 2 IMM 5654 (03-2017) ED Undertaking AND DECLARATIONI mportant: You must read, complete and sign this am applying for a one year, LMIA-exempt work permit under the atlantic immigration have a valid job offer from an employer
Immigration and Refugee Protection Act. and the Immigration and Refugee Protection Regulations. To the best of my knowledge I meet the program requirements of the Atlantic Immigration Pilot. I consent to the collection and disclosure of the information contained herein, including for monitoring and evaluation purposes.
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