Immigration and
Refugee Board of Canada
Immigration Division
Commission de l’immigration
et du statut de réfug du Canada
Section de
l'immigration
cisr.gc.ca/en/contact/Pages/contact3.aspx. Please contact the Canada Border Services Agency directly to obtain
https://irb-
Contact information for each regional office may be found on the IRB website:
if applicable). The Immigration Division accepts applications sent by fax,
email,
courier or that are hand delivered.
Immigration Division and both parties (i.e. Canada Border Services Agency and counsel for the person concerned,
counsel for the person concerned, if applicable). Bondspersons should send the completed application to the
documentation to the Immigration Division and the opposing party (i.e. Canada Border Services Agency or
How to submit a completed form:
Please send your completed application
below
and any supporting
Protection Division to show that your refugee claim has been accepted.
for example a letter of offer or pay stub
to show
evidence of employment or a notice of decision from the Refugee
Supporting documentation:
Please be sure to attach any relevant documentation that supports your application,
completed form to the Division.
release remain in place.
If
you
have
retained counsel, you
may wish to consult with
counsel
before
submitting the
the
application has been granted and
the
conditions have been changed or cancelled,
the existing conditions of
you
may
use this form to make the request. Until
you
receive written confirmation from the Immigration Division that
conditions of release.
If
you
believe there is a reason why
the
conditions
of release
should be changed or cancelled,
What
is
the
purpose
of
this
form:
If
you
have
been
released
by
the
Immigration
Division,
you
must
obey
the
counsel),
bondspersons
and the Canada Border Services Agency.
Who
should
use
this
form:
Persons
who
have
been
ordered
released
by
the
Immigration
Division
(including
IMPORTANT INSTRUCTIONS
AND INFORMATION
APPLICATION TO
VARY
CONDITIONS
OF RELEASE
only where permitted by law.
information is incorrect. In limited instances, we can share your information without your consent, but will do so
Under the
Privacy Act, you have the right to access your personal information and request changes
if the
disclosure of information you provide is protected under the
Privacy Act
and other applicable federal legislation.
Privacy:
The privacy and the protection of your personal information is
important to us. The collection, use and
the Division’s decision.
bondsperson. The Division may contact you if the decision-maker has questions. You will be advised in writing of
track-record of compliance with conditions; or a change in
the financial or personal circumstances of a
personal circumstances, such as the securing of employment or enrolment in a treatment program; a consistent
release is justified, including for example a change in your immigration status in Canada; a change in your
decision. In doing so, it will consider
any relevant factors in determining whether a change in the conditions of
Immigration Division in response to their concerns, should you wish to do so. The Division will then make a
required to share them with you, at which point you will have
three
(3) days to provide additional information to the
the Canada Border Services Agency.
If the Canada Border Services Agency makes submissions, they are
your application will be reviewed and a decision taken
based on your
request
and any
submissions
received from
What happens after the Immigration Division receives your form:
Once received by the Immigration Division,
their fax number or mailing address.
Immigration and
Refugee Board of Canada
Immigration Division
Commission de l’immigration
et du statut defugié du Canada
Section de
l'immigration
APPLICATION TO VARY CONDITIONS OF RELEASE
Date of application: ___________________________________________________________________________
Applicant’s full name: _________________________________________________________________________
Applicant’s mailing address: ____________________________________________________________________
Applicant’s day-time telephone number: ___________________________________________________________
Applicant’s e-mail address: _____________________________________________________________________
Full name of person concerned: _________________________________________________________________
ID file number: ______________________________________________________________________________
UCI / Client ID number: ________________________________________________________________________
What conditions on the release order do you wish to change or cancel? [please list each condition and indicate
whether you wish for it to be changed or cancelled]
Immigration and
Refugee Board of Canada
Immigration Division
Commission de l’immigration
et du statut defugié du Canada
Section de
l'immigration
Why do you wish to have these conditions changed or cancelled? [please outline in detail the reasons why you
believe the Immigration Division should change or cancel the conditions of release]
If requesting to change the frequency and/or method of reporting, please specify the reporting frequency [e.g.
weekly, bi-weekly, monthly] and/or method [e.g. in-person, voice] you are asking for.
The counsel for the person concerned,
by
fax
mail
hand-delivery email
The Canada Border Services Agency, by
fax
mail
hand-delivery
I hereby confirm that a copy of this application was
provided to:
Statement of Service
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