![](https://var.fill.io/uploads/pdfs/html/b8de2a00-5d46-4086-b04b-6b8958db69d4/bg4.png)
PROTECTED "B" WHEN COMPLETED
Immigration and Refugee Board of Canada
http://www.irb-cisr.gc.ca
Appellant's Record Form
Disponible en français
IRB/CISR 3005 (09/18)
Written Statement Concerning the Hearing at the RAD
(Rule 3(3)(d)(ii) and (iii) of the RAD Rules)
1. My name is _______________________________________________________.
2. I am the appellant/ one of the appellants in the appeal at the Refugee Appeal Division (RAD) bearing
number_____________________________________________.
3. I am presenting evidence referred to in subsection 110(4)
1
of the Immigration and Refugee Protection Act
(IRPA).
4. I am requesting that a hearing be held under subsection 110(6)
of the IRPA.
5. I am making an application under Rule 66 of the Refugee Appeal Division Rules to change the lo
location of the hearing.
I am not making an application to change the location of the hearing.
6. I am requesting an interpreter in the ________________________________ language, and in the
_________________________________ dialect, if any, for the purpose of the hearing.
7. I am requesting that the hearing be held in English.
I am requesting that the hearing be held in French.
8. I explain in my Memorandum, at page ____, why the Division should hold a hearing under subsection
110(6)
2
of the IRPA.
1
Section 110(4) of the IRPA reads as follows: On appeal, the person who is the subject of the appeal may present only evidence that
arose after the rejection of their claim or that was not reasonably available, or that the person could not reasonably have been expected
in the circumstances to have presented, at the time of the rejection.
Section 110(6) of the IRPA reads as follows: The Refugee Appeal Division may hold a hearing if, in its opinion, there is documentary
evidence referred to in subsection (3)
(a) that raises a serious issue with respect to the credibility of the person who is the subject of the appeal;
(b) that is central to the decision with respect to the refugee protection claim; and
(c) that, if accepted, would justify allowing or rejecting the refugee protection claim.