Fillable APPLICATION FOR CANADIAN CITIZENSHIP - MINORS (under 18

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APPLICATION FOR CANADIAN CITIZENSHIP - MINORS (under 18

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PAGE 1 OF 5
CIT 0003 (10-2017) E
PROTECTED WHEN COMPLETED -
B
(DISPONIBLE EN FRANÇAIS - CIT 0003 F)
APPLICATION FOR CANADIAN
CITIZENSHIP - MINORS
(under 18 years of age)
under subsection 5(2)
This form is made available by Immigration, Refugees and Citizenship Canada and is not to be sold to applicants.
FOR OFFICIAL USE ONLY
UCI no.
Certificate no.
FOR OFFICIAL USE ONLY
Space reserved
for applicant's label
IMPORTANT INFORMATION:
The parent or guardian applying on behalf of a minor (under 18) who is a permanent resident
should complete this form.
Do not use this form if your child is eligible for citizenship through birth outside Canada to a
Canadian parent (citizenship by descent).
Before you start, read the instructions.
Complete the form on a computer or by hand in block letters with black ink.
1. I want service in English OR French Please check one.
2. Does the child have special
needs that require
accommodation?
No Yes
►
If yes, explain:
3. Have you applied for the child to
obtain citizenship in the past?
No Yes
►
When?
Year
4. A The person applying for the child is the Parent OR Guardian
Print your name
B Is the child legally adopted? No Yes
Note: Guardians can apply but one of the natural or adoptive parents must be a Canadian citizen or applying
to become a Canadian citizen. You must provide a birth certificate, adoption order or a legal document
showing guardianship (see instructions about Quebec issued documents in the section on documents).
5. A What is the child's client ID# or Unique Client Identifier (UCI) as shown exactly on the child's most recent
immigration document?
UCI
B Child's name
(exactly as it
appears on the
immigration
document)
Surname/Last name
Given name(s)
C Your current name, if different from above.
Note: you must provide supporting documents for any change in your name. Consult "Step 1. Gather documents" in the instruction guide.
Surname/Last name
Given name(s)
D List any other names the child has used in the past or now uses (i.e. alias, birth name, nickname) These names will not appear on the child's certificate of citizenship
Surname/Last name
Given name(s)
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PAGE 2 OF 5
CIT 0003 (10-2017) E
6. A Birth details (as shown on the
immigration document)
Date
(YYYY-MM-DD)
Place
City, town, etc. Country
B Indicate the child's current citizenship
C Personal
information
Sex Male Female Height
cm
OR
ft in
Colour of eyes
Marital status
Single Married Common-law Widowed Divorced Separated
7. A Home address
No. and street Apt/Unit
City Province Postal code
B Mailing address
(if different from
home address)
No. and street Apt/Unit
City Province Postal code
C Telephone
no.(s)
Home
Area code and number
Work
Area code and number Ext.
Cell
Area code and number
D E-mail address
(if applicable)
* If you provide us with your email address, we may correspond with you via email.
8. DETAILS OF CHILD'S PARENTS
PARENT
A
Surname/Last name (Maiden name if applicable) Given name(s)
Other name(s) used
B
Country of birth Date of birth (YYYY-MM-DD)
C Was the child's grandparent(s) a Canadian
citizen at the time of their parent's birth
No Yes
D Proof of
Canadian
citizenship
Citizenship certificate number Date on certificate (YYYY-MM-DD)
E Indicate whether the child's parent is the
natural or adoptive parent
Natural Adoptive
F Did the parent leave Canada for more than 1 year before
February 15th, 1977? (see instructions in the guide)
No Yes
From
(YYYY-MM)
To
(YYYY-MM)
Destination (Country)
G Was the parent employed outside Canada as a Crown
servant (in or with the Canadian Armed Forces, the federal
public administration or the public service of a province or
territory other than as a locally engaged person) at the time
of the child's birth or adoption?
No Yes
H Were either of the child's grandparents employed outside
Canada as a Crown servant (in or with the Canadian Armed
Forces, the federal public administration or the public service
of a province or territory other than as a locally engaged
person) at the time of the parent's birth or adoption?
No Yes
PARENT
A
Surname/Last name (Maiden name if applicable) Given name(s)
Other name(s) used
B
Country of birth Date of birth (YYYY-MM-DD)
C Was the child's grandparent(s) a Canadian
citizen at the time of their parent's birth
No Yes
D Proof of
Canadian
citizenship
Citizenship certificate number Date on certificate (YYYY-MM-DD)
E Indicate whether the child's parent is the
natural or adoptive parent
Natural Adoptive
F Did the parent leave Canada for more than 1 year before
February 15th, 1977? (see instructions in the guide)
No Yes
From
(YYYY-MM)
To
(YYYY-MM)
Destination (Country)
G Was the parent employed outside Canada as a Crown
servant (in or with the Canadian Armed Forces, the federal
public administration or the public service of a province or
territory other than as a locally engaged person) at the time
of the child's birth or adoption?
No Yes
H Were either of the child's grandparents employed outside
Canada as a Crown servant (in or with the Canadian Armed
Forces, the federal public administration or the public service
of a province or territory other than as a locally engaged
person) at the time of the parent's birth or adoption?
No Yes
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PAGE 3 OF 5
CIT 0003 (10-2017) E
9. A When did the child become a permanent resident of Canada?
Date (YYYY-MM-DD)
B Has the child left Canada for a total of 6 months or longer since becoming a permanent resident? Yes No
If yes, give details of the time the child spent away from Canada.
FROM
(YYYY-MM-DD)
TO
(YYYY-MM-DD)
DESTINATION
What country did the child go to?
REASON
Why did the child go to this country?
Number of days
absent
days
days
days
days
days
days
days
days
days
days
days
Use another piece of paper if you need more space.
TOTAL
days
C You must include photocopies of the biographical pages of any passports or travel documents covering the five (5) years immediately before the date of the child's application,
or since the child became a permanent resident, if the child became a permanent resident within the past five years.
Do you have all of the required photocopies?
Yes No
►
If no, explain why these documents are not in your possession in the box below.
Note: if your passport validity was extended, include a photocopy of the page(s) containing
the extension stamp(s).
D Are there any gaps in time in the validity period of the child's passports or travel documents during the past five (5) years, or since the child became a permanent resident,
within the past five years?
No Yes
►
If yes, explain why the child's passports or travel documents do not cover the entire period of time in the box below. If you do not provide an
explanation for any period when your child did not have a valid passport, your application will be returned to you.
E In the past four (4) years, was the child present in a country other than Canada for a total of 183 days or more while the child was 14 years of age or older?
Yes No Not applicable (child under 14 years of age)
If you have checked “YES”, indicate each country in the box below. You must provide police certificates for each country where the child has been present for 183 days or
more. If the child cannot get a police certificate from a country, provide an explanation in the box below.
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PAGE 4 OF 5
CIT 0003 (10-2017) E
10. PROHIBITIONS UNDER THE CITIZENSHIP ACT
A Is the child now:
• on probation in Canada?
►
No Yes
• on parole in Canada?
►
No Yes
• serving a term of imprisonment in Canada?
►
No Yes
B Is the child now serving a sentence outside Canada for an offence?
►
No Yes
C Is the child now charged with, on trial for, or subject to or a party to an appeal relating to an offence under the Citizenship Act or an indictable
offence in Canada?
►
No Yes
D Is the child now charged with, on trial for, or subject to or a party to an appeal relating to an offence committed outside Canada?
►
No Yes
E Is the child now, or has the child ever been, under a removal order (has the child been asked by Canadian officials to leave Canada)?
►
No Yes
F Is the child now under investigation for, charged with, on trial for, subject to or a party to an appeal relating to or has the child ever been
convicted of a war crime or a crime against humanity?
►
No Yes
G In the past five (5) years, was the child prohibited from being granted citizenship or taking the Oath of Citizenship for reasons of
misrepresentation or withholding of material circumstances?
►
No Yes
H In the past four (4) years, has the child been convicted in Canada of an indictable offence under any Act of Parliament or an offence under
the Citizenship Act?
►
No Yes
I In the past four (4) years, has the child been convicted outside Canada of an offence, regardless of whether the child was pardoned or
otherwise granted amnesty for the offence?
►
No Yes
J While a permanent resident, has the child:
• been convicted in Canada of terrorism, high treason, treason, or spying offences?
►
No Yes
• been convicted outside Canada of terrorism?
►
No Yes
• served as a member of an armed force of a country OR organized armed group and that country or group engaged in
armed conflict with Canada?
►
No Yes
I am the parent or guardian of this child. I have read and understand the prohibitions under the Citizenship Act.
If you have checked "YES" to any of the prohibitions listed above, provide details below. If applicable, attach court documents.
11. APPOINTMENT OF A REPRESENTATIVE
Are you appointing an individual, firm or organization as your representative?
►
No Yes
►
If yes, the Use of a Representative form (IMM 5476) must
be completed and included with your application.
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PAGE 5 OF 5
CIT 0003 (10-2017) E
12. SIGNATURE(S)
I agree to advise Immigration, Refugees and Citizenship Canada (IRCC) if any information on this form changes before the child takes the Oath of Citizenship. I understand the
content of this form. I declare that the information provided is true, correct and complete, and that the photographs enclosed are a true likeness of the child. I understand that if I
or someone on my behalf, make a false representation, or commit fraud or conceal any material circumstances relevant to the child's application, the child could be prohibited
from becoming a citizen and reapplying for citizenship for five years, the child's citizenship could be revoked and I could be charged with an offence as provided for under the
Citizenship Act, or the Criminal Code.
Note: IRCC may verify the authenticity and accuracy of any documents you have provided in support of your application for a minor grant of citizenship with the
body that issued the documents.
I have read and understand the prohibitions under the Citizenship Act.
PARENT'S/GUARDIAN'S Signature
(you must sign inside the white box in black ink only)
City Date (YYYY-MM-DD)
Children (14 years of age and older) must also sign this application:
CHILD'S Signature
(you must sign inside the white box in black ink only)
City Date (YYYY-MM-DD)
REMEMBER:
If you are sending more than one application, send all of them together in one envelope.
The applications will be processed together.
Protected Information
Personal Information Bank CIC PPU 050
The information you provide on this form is collected under the authority of the Citizenship Act to determine whether your citizenship application may be approved. It will be stored in
the Personal Information Bank (CIC PPU 050 entitled Application and Assessment for Canadian Citizenship). The information may be shared with other Canadian government
institutions such as the Canada Border Services Agency (CBSA), the Royal Canadian Mounted Police (RCMP), the Canadian Security Intelligence Service (CSIS), and foreign
governments in accordance with the Citizenship Regulations and subsection 8(2) of the Privacy Act. Information may also be disclosed to foreign governments, law enforcement
bodies and detaining authorities with respect to the administration and enforcement of citizenship legislation where such sharing of information may not put the individual and/or his/
her family at risk. Information may also be systematically validated by other Canadian government institutions under the terms of an agreement or arrangement for the purposes of
validating status and identity to administer their programs. In accordance with the Privacy Act and the Access to Information Act, individuals have a right to protection of, access to
and correction of their personal information. Details on these matters are available at the InfoSource Website at http://infosource.gc.ca
. InfoSource is also available at public libraries
across Canada.
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APPLICATION FOR CANADIAN CITIZENSHIP - MINORS (under 18

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Completed 23 October 2021

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