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FINANCIAL EVALUATION FOR PARENTS AND GRANDPARENTS SPONSORSHIP (Government of Canada)

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(DISPONIBLE EN FRANÇAIS - IMM 5768 F)
PROTECTED WHEN COMPLETED - B
Page 1 of 4
FINANCIAL EVALUATION FOR PARENTS AND GRANDPARENTS SPONSORSHIP
IMM 5768 (06-2019) E
BEFORE YOU START, READ THE INSTRUCTION GUIDE.
TYPE or PRINT in black ink.
ABOUT YOU AND, IF APPLICABLE, YOUR CO-SIGNER
1. A) Is your spouse or common-law partner co-signing the undertaking?
No Yes
Give the following details.
Full name of your spouse or common-law partner
Family name Given name(s) Date of birth (YYYY-MM-DD)
B) Your full name
Family name Given name(s)
The information you provide on this form is collected under the authority of the Immigration and Refugee Protection Act and Regulations and will be used in assessing your
eligibility as a sponsor according to the regulatory requirements. It will be retained in the Personal Information Bank CIC PPU 013. 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 Immigration, Refugees and Citizenship Call Centre. Infosource is
also available at Public Libraries in Canada.
YOUR FAMILY MEMBERS AND PERSONS INCLUDED IN UNDERTAKINGS IN EFFECT OR NOT YET IN EFFECT SIGNED BY YOU AND, IF APPLICABLE, YOUR CO-SIGNER
2. You
3. A) Current undertaking
Number of persons included in box #3 of the Generic Application Form for Canada (IMM 0008), under section Application Details.
B) Previous undertakings
i) Number of persons included in previous undertakings you signed as a sponsor and that are still in effect. Provide details in question 9 on page 2.
ii) Number of persons included in previous undertakings you signed as a sponsor and that are not yet in effect (persons who have not yet become permanent
residents). Provide details on the back of this page.
iii) Number of persons included in previous undertakings you co-signed, where these undertakings are still in effect. Provide details on the back of this page.
iv) Number of persons included in previous undertakings you co-signed, where these undertakings are not yet in effect (persons who have not yet become
permanent residents). Provide details on the back of this page.
4. Complete this section only if your spouse or common-law partner is co-signing the undertaking
i) Number of persons included in previous undertakings your spouse or common-law partner signed as a sponsor and that are still in effect. Do not include persons
already accounted for in 2. or 3.B(iii). Provide details on the back of this page.
ii) Number of persons included in previous undertakings your spouse or common-law partner signed as a sponsor and that are not yet in effect (persons who have
not yet become permanent residents). Do not include persons already accounted for in question 3.B(iv). Provide details in question 10 on page 2.
iii) Number of persons included in previous undertakings your spouse or common-law partner co-signed, where these undertakings are still in effect. Do not include
persons already accounted for in question 3.B(i). Provide details on the back of this page.
iv) Number of persons included in previous undertakings your spouse or common-law partner co-signed, where these undertakings are not yet in effect (persons who
have not yet become permanent residents). Do not include persons already accounted for in question 3.B(ii). Provide details on the back of this page.
5. Your spouse or common-law partner, if not included in 3. above. Provide details on the back of this page if they are not co-signing the undertaking.
6. Every other family member not included above and dependent on you financially, whether they are living with you or not. Enter their number in the box on the right
and provide details on the back of this page.
FINANCIAL REQUIREMENT
7. Total number of persons for the purpose of determining your minimum necessary income.
Add the numbers entered in the boxes 2, 3, 4, 5, and 6 above and write the total here.
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Page 2 of 4
IMM 5768 (06-2019) E
8. Sponsor - Statement of Consent
By selecting "Yes" in the box below, and by signing this statement, I hereby give consent to Immigration, Refugees and Citizenship Canada (IRCC) to collect my Social Insurance
Number (SIN) for the purpose of requesting that the Canada Revenue Agency (CRA) disclose my income tax information for the three consecutive years immediately preceding
the date of the application in order to determine whether the sponsor meets the minimum necessary income requirements (Low-Income-Cut-Offs + 30%) to sponsor a parent or
grandparent as outlined in section 133(1)(j(i)(B) of the Immigration and Refugee Protection Regulations (IRPR).
If you check "No", you must provide the information requested on the Income Sources for the Sponsorship of Parents and Grandparents (IMM 5748).
Yes No
S.I.N. Signature Date (YYYY-MM-DD)
9. Details of your family members and persons included in undertakings in effect or not yet in effect signed by you and, if applicable, your co-signer.
Given name(s)
Date of birth
(YYYY-MM-DD)
Persons included in previous undertakings you signed as a sponsor and that are still in effect. (see 3.B i) on page 1)
Persons included in previous undertakings you signed as a sponsor and that are not yet in effect. (see 3.B ii) on page 1)
Persons included in previous undertakings you co-signed and that are still in effect. (see 3.B iii) on page 1)
Persons included in previous undertakings you co-signed and that are not yet in effect. (see 3.B iv) on page 1)
Family name
10. Complete this section only if your spouse or common-law partner is co-signing the undertaking.
Persons included in previous undertakings your spouse or common-law partner signed as a sponsor and that are still in effect. (see 4 i) on page 1)
Persons included in previous undertakings your spouse or common-law partner signed as a sponsor and that are not yet in effect. (see 4 ii) on page 1)
Persons included in previous undertakings your spouse or common-law partner co-signed and that are still in effect. (see 4 iii) on page 1)
Persons included in previous undertakings your spouse or common-law partner co-signed and that are not yet in effect. (see 4 iv) on page 1)
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Page 3 of 4
IMM 5768 (06-2019) E
11. Your spouse or common-law partner, if they are not co-signing the undertaking.
12. Every other family member not listed above and dependent on you financially, whether they are living with you or not.
13. Your current situation
Check the box below which best describes your current situation.
Unemployed ► Give details of your current situation and indicate how you support yourself. If you need additional space, provide details on a separate sheet of paper.
Employed ► You are working for an employer and are paid a salary, wages or a commission for your services.
Self-employed ► You have your own business, practice a trade or a profession and conduct activities for a profit.
From
(YYYY-MM-DD)
To
(YYYY-MM-DD)
Employer name Address Phone no.
Gross income/
Benefits
for period
Family
size
Present
14. Provide your employment history as well as periods of unemployment for the last THREE consecutive taxation years preceding your application. Please ensure that
you do not leave any gaps in time.
EMPLOYMENT HISTORY - SPONSOR
15. Your spouse's/common-law partner's current situation
Check the box below which best describes your spouse's/common-law partner's current situation.
Unemployed ► Give details of your spouse's/common-law partner's current situation and indicate how they support themself. If you need additional space, provide
details on a separate sheet of paper.
Employed ► Your spouse/common-law partner is working for an employer and is paid a salary, wages or a commission for their services.
Self-employed ► Your spouse/common-law partner has their own business, practice a trade or a profession and conducts activities for a profit.
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Page 4 of 4
IMM 5768 (06-2019) E
16. Co-signer - Statement of Consent
By selecting "Yes" in the box below, and by signing this statement, I hereby give consent to Immigration, Refugees and Citizenship Canada (IRCC) to collect my Social Insurance
Number (SIN) for the purpose of requesting that the Canada Revenue Agency (CRA) disclose my income tax information for the three consecutive years immediately preceding
the date of the application in order to determine whether the sponsor meets the minimum necessary income requirements (Low-Income-Cut-Offs + 30%) to sponsor a parent or
grandparent as outlined in section 133(1)(j(i)(B) of the Immigration and Refugee Protection Regulations (IRPR).
If you check "No", you must provide the information requested on the Income Sources for the Sponsorship of Parents and Grandparents (IMM 5748).
Yes No
S.I.N. Signature Date (YYYY-MM-DD)
From
(YYYY-MM-DD)
To
(YYYY-MM-DD)
Employer name Address Phone no.
Gross income/
Benefits
for period
Family
size
Present
17. Provide your co-signer's employment history as well as periods of unemployment for the last THREE consecutive taxation years preceding your application. Please
ensure that you do not leave any gaps in time.
EMPLOYMENT HISTORY - CO-SIGNER
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FINANCIAL EVALUATION FOR PARENTS AND GRANDPARENTS SPONSORSHIP (Government of Canada)

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Completed 26 September 2021

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