Fillable APPLICATION FOR A PERMANENT RESIDENT CARD (Canadian Immigration and Study Abroad Information Platform)

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APPLICATION FOR A PERMANENT RESIDENT CARD (Canadian Immigration and Study Abroad Information Platform)

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The APPLICATION FOR A PERMANENT RESIDENT CARD (Canadian Immigration and Study Abroad Information Platform) form is 4 pages long and contains:

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Country of origin: CANADA
File type: PDF

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Year Month Day
Confused by a question? See step 2 of the instruction guide.
C. ADDRESS, WORK AND EDUCATIONAL HISTORY FOR THE PAST FIVE YEARS
This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants.
2. Date you became a permanent resident
of Canada
3. You are applying to (check one box):
Replace a lost, stolen, destroyed or never
received Permanent Resident Card
PROTECTED WHEN COMPLETED - B
PAGE 1 OF 4
APPLICATION FOR A PERMANENT RESIDENT CARD
(DISPONIBLE EN FRANÇAIS - IMM 5444 F)
IMM 5444 (01-2010) E
Citizenship and
Immigration Canada
Citoyenneté et
Immigration Canada
NOTE: If you are applying to renew your present card and
a) your card has expired, you should return it with this application;
b) your card is still valid you may hold on to it and return it to the Citizenship and Immigration Canada officer when you pick-up your new card
at a local CIC office.
If you are applying to replace your damaged card, you should return your card with this application.
Obtain your first
Permanent Resident Card
Renew your present
Permanent Resident Card
B. YOUR IMMIGRATION HISTORY
16. Place you became a permanent resident of Canada
City
Province
17. Have you ever been issued a removal order in Canada?
No
Yes
18. Has an Immigration Officer ever issued you a Report Under
Subsection 44(1) or made the decision that you have not met
the residency obligations required of Canadian permanent
residents?
No
Yes
19. Your address history for the past 5 years or if you became a permanent resident less than five years ago, your address history since becoming a
permanent resident
City or town
M MY Y
From To
Street and number
1. Language you prefer for correspondence:
English
French
TYPE or PRINT in black or blue ink
4. Your full name as shown on your Record of Landing (IMM 1000) or
Confirmation of Permanent Residence (IMM 5292).
Family name
(Surname)
Given name(s)
7. Your date of birth
12. Your current
residential
address in
Canada
5. Your current name, if different from above
(Note: you must provide supporting documents for any change in your
name. Consult the Document Checklist (IMM 5574))
Family name
(Surname)
Given name(s)
A. PERSONAL DETAILS
11. Your height
cm
or
ft in
10. Colour of
your eyes
Blue
Green
Grey
Black
Brown
Hazel (yellowish brown)
Other
13. Your mailing
address in
Canada
(if different
from above)
15. Your current marital status
Never married Married Widowed
Legally separated Divorced Common-law
Postal Code
Postal Code
14. Your telephone numbers
Area code Number
( )
( )
At home
Alternative
9. Your country
of citizenship
8. Your country
of birth
6. Your sex
Female
Male
CountryProvince
Year Month Day
Fillable Form
IMM 5444 (01-2010) E
M MY Y
PAGE 2 OF 4
C. ADDRESS, WORK AND EDUCATIONAL HISTORY FOR THE PAST FIVE YEARS (continued)
21. Have you travelled or lived outside of Canada in the last five years (or if you became a permanent resident less than five years ago, since becoming a
permanent resident)?
Reason for absence Number of days
20. Your work and/or educational history for the past 5 years or if you became a permanent resident less than five years ago, your work and/or educational
history since becoming a permanent resident. If you have not worked or studied, write N/A (not applicable).
CountryProvince
MY
To
Y M
From
From To
Name of employer or name of educational institution
attended (do not use abbreviations)
Your location during your absence (city, country)
List all your absences:Yes
No
If your total equals 1095 days or more, you must complete Section D.
Complete this section if you have been outside of Canada for 1095 days or more in the past five years.
Option 1 - Absence while accompanying a family member who is a Canadian citizen
Name of family member
Relationship to you
Option 2 - Absence while employed by a Canadian business or in the Canadian federal or provincial public service
D. RESIDENCY OBLIGATION
22. If you have been outside of Canada for 1095 days or more, list your absences from Canada in the past five years in the following situations, if applicable.
If you became a permanent resident less than five years ago: list absences from the time you became a permanent resident to present.
Provide proof of your relationship.
Provide proof of Canadian citizenship.
M MY Y
From To
Your address during your absence Number of days
M MY Y
From To
Your address during your absence Number of days
Provide proof of full-time Canadian employment
City or town
Total number of days
Total number of days
Total number of days
IMM 5444 (01-2010) E
z I declare that the information I have given is truthful, complete and correct.
z I understand that any false statements or concealment of a material fact may be grounds for my prosecution or removal.
z The photographs enclosed are a true likeness of me.
z I am a permanent resident of Canada.
z I am not a Canadian citizen.
z I understand all the foregoing statements, having asked for and obtained an explanation on every point that was not clear to me.
z I realize that once this document has been completed and signed, it will form part of my Immigration Record and will be used to verify my family details on
future applications.
z I will immediately inform Citizenship and Immigration Canada if any of the information or the answers provided in my application forms change.
E. DECLARATION OF APPLICANT
PAGE 3 OF 4
D. RESIDENCY OBLIGATION (continued)
Option 3 - Absence while accompanying a family member who is a permanent resident of Canada and who is employed by a Canadian business or in
the Canadian federal or provincial public service
Name of family member
Relationship to you
Provide proof of your relationship.
Provide proof of this person's permanent resident status and
proof of this person's full-time employment.
M MY Y
From To
Your address during your absence Number of days
City
Province
Signature
of declarant
Date
Signature of parent
or guardian, if applicable
Date
I am the applicant's:
(check appropriate box)
23. This declaration covers the information that I have provided on this form and all the information submitted in my application for a Permanent Resident
Card as well as in the attached accompanying documents.
Total number of days
Year Month Day
FatherMother Guardian
Year Month Day
IMM 5444 (01-2010) E
PAGE 4 OF 4
Permanent Resident Card number Date of issue
My Permanent Resident Card was Lost
Under the following circumstances (full information must be provided below):
I have made the following efforts to locate this document
(if applicable, indicate police authorities notified and attach a copy of police report or incident report number):
Should I ever regain possession of my original PR Card, I promise to return it immediately to a Citizenship and Immigration Centre, or, if I am outside Canada, to the
nearest Canadian Embassy, Consulate or High Commission.
I solemnly declare that the information I have provided is true, that is of the same force and effect as if made under oath, and that it was freely given. I authorize the
department of Citizenship and Immigration Canada to verify the information I have provided. I also understand that the provision of any false or misleading
information may lead to prosecution in accordance with Section 127 of the Immigration and Refugee Protection Act.
F. SOLEMN DECLARATION CONCERNING A LOST, STOLEN, DESTROYED OR NEVER RECEIVED PERMANENT RESIDENT CARD
Destroyed Never received
Stolen
on or about
The information you provide on this form is collected under the authority of the Immigration and Refugee Protection Act and will be used to determine whether the term
and conditions of your permanenet residency were maintained and whether you should be granted a Permanent Resident Card. It will be retained in the Personal
Information Bank CIC PPU 067 entitled Permanent Resident Card as identified in Infosource. It may be shared with other organizations in accordance with the
consistent use of information under the Privacy Act. Under the Privacy Act and the Access to Information Act individuals have the right to protection of and access to
their personal information. Details on these matters are available at infosource.gc.ca and through the Citizenship and Immigration Call Centre. Infosource is also
available at Public Libraries in Canada.
24. Complete this section only if you are applying to replace a lost, stolen, destroyed or never received PR Card.
Year Month Day
Signature
of declarant
Date
Signature of parent
or guardian, if applicable
Date
Year Month Day
Year Month Day
at
Year Month Day
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APPLICATION FOR A PERMANENT RESIDENT CARD (Canadian Immigration and Study Abroad Information Platform)

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Completed 16 June 2021

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