For office use only
Received on:
Disponible en français Immigration and Refugee Board of Canada
http://www.irb-cisr.gc.ca
Application for an Extension of Time to File or Perfect an Appeal
RAD.00 (2017/01) Page 1 of 3
Application for an Extension of Time to File or Perfect an Appeal
Subsection 159.91(2) of the Immigration and Refugee Protection Regulations
Rules 6 and 37 of the Refugee Appeal Division Rules
Select one of the following:
Application for an extension of time to file and perfect an appeal:
Refugee Protection Division (RPD) decision: _______________________________ ___________________________________
Date of the notice of decision Date RPD reasons received
(yyyy/mm/dd) (yyyy/mm/dd)
Important: Attach three copies of the Notice of Appeal and two copies of the Appellant’s Record. Provide any evidence in support of this application in an
original affidavit or statutory declaration.
Application for an extension of time to perfect an appeal:
Refugee Appeal Division (RAD) file no.: _______________________________
Important: Attach two copies of the Appellant’s Record. Provide any evidence in support of this application in an original affidavit or statutory declaration.
Appellant
RPD file no.
Signature of appellant/
designated
representative
Language
chosen for
appeal
Representative
designated by
RPD
___________________________________________
LAST NAME, first name, middle name(s)
___________________________________________
Date of birth
___________________________________________
Country of nationality/Country of citizenship
English
French
None
Yes. Provide
information
on page 3.
Unique client
identifier
Date signed
(yyyy/mm/dd)
___________________________________________
LAST NAME, first name, middle name(s)
___________________________________________
Date of birth
___________________________________________
Country of nationality/Country of citizenship
English
French
None
Yes. Provide
information
on page 3.
Unique client
identifier
Date signed
(yyyy/mm/dd)
___________________________________________
LAST NAME, first name, middle name(s)
___________________________________________
Date of birth
___________________________________________
Country of nationality/Country of citizenship
English
French
None
Yes. Provide
information
on page 3.
Unique client
identifier
Date signed
(yyyy/mm/dd)
___________________________________________
LAST NAME, first name, middle name(s)
___________________________________________
Date of birth
___________________________________________
Country of nationality/Country of citizenship
English
French
None
Yes. Provide
information
on page 3.
Unique client
identifier
Date signed
(yyyy/mm/dd)
RAD file no.:
Unique client identifier:
Disponible en français Immigration and Refugee Board of Canada
http://www.irb-cisr.gc.ca
Application for an Extension of Time to File or Perfect an Appeal
RAD.00 (2017/01) Page 2 of 3
NOTE: For reasons of fairness and natural justice, the RAD may extend the time limit to file or perfect an appeal.
Provide the detailed reasons for which you require the extension of time on the lines below. You may attach additional sheets of
paper the same size as this form if needed as well as documents to support your request.
RAD file no.:
Unique client identifier:
Disponible en français Immigration and Refugee Board of Canada
http://www.irb-cisr.gc.ca
Application for an Extension of Time to File or Perfect an Appeal
RAD.00 (2017/01) Page 3 of 3
Address of appellant
No. and street
Apt. no.
City
Province
Postal code
( )
Area code Home telephone
( )
Area code Work telephone
( )
Area code Home fax
( )
Area code Work fax
Counsel contact information
Name (Mr./Ms)
Law firm or company
No. and street
Apt. no.
City
Province
Postal code
( )
Area code Telephone no.
( )
Area code Fax no.
Electronic mail address
Membership no.
Lawyer / Paralegal / Notary : _____________________________________
Province
Immigration Consultants of Canada Regulatory Council (ICCRC)
Family member or other person helping with this appeal: (Please complete the Notice of representation without a fee or other consideration and provide it to the
RAD with these documents.)
Limitation on retainer: _________________________________________________________________________________________________________________________
Note: The Immigration and Refugee Protection Act makes it an offence for any person not authorized under the Act to knowingly, directly or indirectly, represent or advise a
person for consideration or offer to do so in connection with a proceeding under this Act. (Consideration includes money, or any other form of compensation or reward.)
I have been retained to represent the appellant(s) named above for their appeal before the RAD.
________________________________________________ ________________________________________________
Signature of counsel Date (yyyy/mm/dd)
Designated representative information
(if one was designated by RPD)
Name (Mr./Ms)
Relationship (if applicable)
Organization or company (if applicable)
No. and street
Apt. no.
City
Province
Postal code
( )
Area code Telephone no.
( )
Area code Fax no.
Electronic mail address
Interpreter’s declaration
I, (print full name clearly) _______________________________________________________________, hereby declare that I have accurately interpreted the entire content of
this form to the appellant(s) from the English to the ______________________________________________________________ language (state dialect if applicable). I am
proficient in both these languages (and dialect, if any) and was able to communicate fully with the appellant(s). The appellant(s) indicated that he/she/they fully understand(s)
the entire content of this form as interpreted by me.
_________________________________________________ ________________________________________________
Signature of interpreter Date (yyyy/mm/dd)
click to sign
signature
click to edit
click to sign
signature
click to edit
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