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Child General Passport Application - canada.ca

Child General Passport Application for Canadians under 16 years of age applying in Canada or from the USAPROTECTED WHEN COMPLETED - BWarning: Any false or misleading statement with respect to this Application and any supporting document, including the concealment of any material fact, may result in the refusal to issue a Passport , the revocation of a currently valid Passport , or the refusal of Passport services, and may be grounds for criminal prosecution. Your Application will not be processed if you fail to complete all of the required sections of this form and/or refuse to consent to the exchange or disclosure of any personal information required for the delivery of Passport or print in CAPITAL LETTERS using black or dark blue 's Personal Information (see Instructions, section I)1 Surname (last name)Given name(s)Surname (last name) at birthFormer surname (last name)Date of birthYearMonthDayPlace of (if applicable)SexFemaleMaleNatural eye colourHeight(cm/in)Current home addressNumberStreetApartmentCityProvince /Territory/StatePostal/ZIP codeMailing address (if different f)

Child General Passport Application for Canadians under 16 years of age applying in Canada or from the USA PROTECTED WHEN COMPLETED - B Warning: Any false or misleading statement with respect to this application and any supporting document, including the concealment

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Transcription of Child General Passport Application - canada.ca

1 Child General Passport Application for Canadians under 16 years of age applying in Canada or from the USAPROTECTED WHEN COMPLETED - BWarning: Any false or misleading statement with respect to this Application and any supporting document, including the concealment of any material fact, may result in the refusal to issue a Passport , the revocation of a currently valid Passport , or the refusal of Passport services, and may be grounds for criminal prosecution. Your Application will not be processed if you fail to complete all of the required sections of this form and/or refuse to consent to the exchange or disclosure of any personal information required for the delivery of Passport or print in CAPITAL LETTERS using black or dark blue 's Personal Information (see Instructions, section I)1 Surname (last name)Given name(s)Surname (last name) at birthFormer surname (last name)Date of birthYearMonthDayPlace of (if applicable)SexFemaleMaleNatural eye colourHeight(cm/in)Current home addressNumberStreetApartmentCityProvince /Territory/StatePostal/ZIP codeMailing address (if different from current home address)

2 NumberStreetApartmentCityProvince/Territ ory/StatePostal/ZIP codeChildren 11 years of age or over must sign in this signature box. Note: At no time should a person other than the Child sign in this signature box, without atCity Province/Territory/StateSign within borderSignature of Child (see Instructions, section I)Date of travelUnknownMonthDayInformation on Applicant (see Instructions, section J)2 NoYesNoYesIf yes, include all documentsRelationship between the applicant (parent or legal guardian) and the other parent or legal guardianDate of marriage (if applicable)YearMonthDayApplicant (parent or legal guardian)Surname (last name) at your birthGiven name(s)Date of birthYearMonthDayCountry of birthAddressTelephone (daytime)Telephone (other)

3 Email addressDeclaration I declare that the Child named above is a Canadian citizen, that I am the parent or legal guardian of this Child and that the statements made in this Application are true. I declare that I have read and understood the Warning at the top of this page and the Privacy Notice Statement (see section O). I consent to the collection, use and disclosure of my personal information and that of the Child by the Passport Program, Immigration, Refugees and Citizenship Canada, other federal government institutions, Government of Canada offices abroad and third party entities as outlined in the Privacy Notice Statement in the of applicant (also sign section 5)DateSigned atOther parent or legal guardianSurname (last name) at your birthGiven name(s)Date of birthYearMonthDayCountry of birthAddressTelephone (daytime)Telephone (other)Email addressDeclaration I declare that the Child named above is a Canadian citizen, that I am the parent or legal guardian of this Child and that the statements made in this Application are true.

4 I declare that I have read and understood the Warning at the top of this page and the Privacy Notice Statement (see section O). I consent to the collection, use and disclosure of my personal information and that of the Child by the Passport Program, Immigration, Refugees and Citizenship Canada, other federal government institutions, Government of Canada offices abroad and third party entities as outlined in the Privacy Notice Statement in the of other parent or legal guardianDateSigned atIs the Child currently the subject of an adoption process or partially or fully in the care of a provincial or territorial family services organization in Canada?Are there any separation agreements, court orders or legal proceedings pertaining to custody of, mobility of, or access to the Child ?

5 Aussi accessible en fran ais - PPTC 156- Page 1 of 8 Previous Canadian Travel Document (see Instructions, section K)3 Has a Canadian travel document ( Passport , certificate of identity or refugee travel document) been issued to the Child ?NoYes (specify)NumberDate of issueYearMonthDayIf the Canadian travel document is still valid, you must include it with your , please return it to : If a valid Canadian travel document has been lost, stolen, damaged or is inaccessible, complete form PPTC 203, Declaration concerning lost, stolen, inaccessible, damaged or found Canadian travel document, available online at A Canadian travel document, once reported lost or stolen, is no longer valid. There is an administrative fee for the replacement of a valid lost or stolen Canadian travel document (see section D).

6 Would you like the previous Passport returned to you? If not, it will be securely destroyed by the Passport Program to protect the Child 's personal of Canadian Citizenship (see Instructions, sections J and L)4 Provide one (1) of the documents listed below (original only):(to be completed if the Child was born in Canada)Birth certificate in CanadaCertificate of Canadian citizenshipRegistration numberDate of issueCertificate numberDate of issue or Effective date of citizenshipDeclaration of Applicant5 Surname (last name) of applicantGiven name(s) of applicantRelationship to the childSurname (last name) of childGiven name(s) of childDeclaration I solemnly declare that the Child named above is a Canadian citizen, that the photos enclosed are unaltered and a true likeness of the Child , that all of the statements made and the information provided in this Application , as well as any supporting documents, are true.

7 I declare that I have read and understood the Warning on page 1 and the Privacy Notice Statement (see section O). I consent to the collection, use and disclosure of my personal information and that of the Child by the Passport Program, Immigration, Refugees and Citizenship Canada, other federal government institutions, Government of Canada offices abroad and third party entities as outlined in the Privacy Notice Statement in the of applicantDateYearMonthDaySigned atCity Province/Territory/StateDeclaration of Guarantor (see Instructions, section M) The guarantor must know the applicant identified in section (last name) in passportGiven name(s)Date of birthYearMonthDayCanadian Passport numberDate of issueYearMonthDayDate of expiryYearMonthDayRelationship to the applicant (parent or legal guardian)Telephone (daytime)

8 Telephone (other)Current home addressNumberStreetApartmentCityProvince /Territory/StatePostal/ZIP codeFull name of applicant (parent or legal guardian)Full name of childI have known the applicant (parent or legal guardian) forNumber of yearsDeclaration I solemnly declare that I have known the applicant identified above personally for at least two (2) years and have knowledge of the Child . I have signed the back of one (1) photo to certify that the image is a true likeness of the Child . I declare that I have read and understood the Warning on page 1 and the Privacy Notice Statement (see section O). I consent to the collection, use and disclosure of my personal information by the Passport Program, Immigration, Refugees and Citizenship Canada, other federal government institutions, Government of Canada offices abroad and third party entities as outlined in the Privacy Notice Statement in the of guarantorDateYearMonthDaySigned atCity Province/Territory/StateEmergency Contact Information (optional) (see Instructions, section N)7 Surname (last name)Given name(s)Relationship to the childTelephone (daytime)Telephone (other)

9 Email addressCurrent home addressNumberStreetApartmentCityProvince /Territory/StatePostal/ZIP code- Page 2 of 8 Child General Passport Application for Canadians under 16 years of age applying in Canada or from the USAI nstructionsEntitlement to a Canadian PassportAImportant notice: We recommend that you not finalize your travel plans until you receive the requested Canadian Passport is the only reliable and universally accepted travel and identification document for Canadians who travel passports are issued to Canadian citizens only and reflect the Child 's identity, as determined by proof of Canadians 16 years of age or over, use form PPTC 153, Adult General Passport Application . Who May Apply for a Passport for a Child ?

10 BOne of the Child 's parentsThe Child 's custodial parent in cases of separation or divorceThe Child 's legal guardianRequirements ChecklistCBoth pages of the Application form completed and signed within the last twelve (12) months and certified by the guarantorTwo (2) identical and unaltered Passport photos of the Child taken within the last six (6) months, one (1) certified by the guarantorProof of Canadian citizenship (original only); the document will be returned to youAny valid Canadian travel document ( Passport , certificate of identity or refugee travel document) issued to the childAcceptable proof of parentageAll documents (including any divorce judgment) that refer to custody of, mobility of, or access to the childThe feeNote: All documents submitted throughout the Passport Application process that are in a language other than English or French must be translated by a certified documents or information may be requested in support of this and Period of ValidityDWhere the Application is made in Canada and the Passport is to be delivered in Canada.


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