Fillable Form 1: ADULT ABROAD SIMPLIFIED RENEWAL PASSPORT APPLICATION (Government of Canada)

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Form 1: ADULT ABROAD SIMPLIFIED RENEWAL PASSPORT APPLICATION (Government of Canada)

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Page 1 of 5
ADULT ABROAD SIMPLIFIED RENEWAL PASSPORT APPLICATION
for Canadians applying outside of Canada and the USA
Warning: Any false or misleading statement with respect to this application and any supporting document, including the concealment of any material fact, may
result in the refusal to issue a passport, the revocation of a currently valid passport, and/or the imposition of a period of refusal of passport services, and may
be grounds for criminal prosecution as per subsection 57 (2) of the Criminal Code (R.C.S. 1985, C-46).
PPTC 482 (02-2021) (DISPONIBLE EN FRANÇAIS - PPTC 483)
Type or print in CAPITAL LETTERS using black or dark blue ink.
1
PERSONAL INFORMATION (SEE INSTRUCTIONS, SECTION H)
Surname (last name) as it appears in the previous passport
Given name(s) as it appears in the previous passport
Anticipated date of travel
Unknown
Month
Day
It is recommended that you do not
finalize travel plans until you
receive the requested passport.
All former surnames (including surname at birth if different from above. These will not appear in the passport.)
Mother's surname at birth
Place of birth
City Country
Prov./Terr./State (if applicable)
Date of birth as it
appears in the previous
passport
(YYYY-MM-DD)
Sex as it appears in the previous passport
F Female M Male X Another gender
Natural eye colour Height (cm or in)
Current home address
Number Street Apt. City
Country Postal/ZIP code
Mailing address (if different from current home address)
Number Street Apt.
City
Country
Postal/ZIP code
Email address Telephone (daytime) Telephone (other)
Declaration—I solemnly declare that I am a Canadian citizen, that all of the information
provided and all statements made on this application, as well as all documents and photos
submitted to support this application are unaltered and true. I declare that I have read and
understood the Warning at the top of this page and the Privacy Notice Statement in
Instructions, section J. I consent to the collection, use and disclosure of my personal
information as outlined in the Privacy Notice Statement.
Sign within border
Signature (see Instructions, section H)
Date (YYYY-MM-DD) Signed at
City Country
2
PREVIOUS CANADIAN PASSPORT (SEE INSTRUCTIONS, SECTION I)
• Enclose any Canadian passport issued to you that is not expired or is expired for less than one year from the date the application is submitted.
Passport number Date of issue (YYYY-MM-DD) Date of expiry (YYYY-MM-DD)
If you cannot submit the previous passport, or if the previous passport is damaged, or was ever reported lost or stolen, you cannot use this form. Any passport
that is damaged, or was ever reported lost or stolen will not be returned. Unreturned passports will be securely destroyed to protect your personal information.
• Would you like the previous passport to be cancelled and returned to you?
Yes, please return it to me. If this box is not checked, the passport will not be returned and will be securely destroyed.
3
CANADIAN CITIZENSHIP
To be completed if you were born outside of Canada between February 15, 1977 and April 16, 1981 inclusive.
a) Are you a naturalized Canadian, i.e. did you receive Canadian citizenship following immigration to Canada?
Yes, go to page 2 No, continue to question b)
b) Was one of your parents born in Canada?
Yes, go to page 2 No, continue to question c)
c) When was your current certificate of Canadian citizenship issued?
After January 1, 2007, submit the certificate with your application (original only).
Before January 1, 2007, complete and submit form PPTC 001, Proof of Canadian Citizenship—Additional Information, available online
at Canada.ca/passport.
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Page 2 of 5
PPTC 482 (02-2021)
4
PERIOD OF VALIDITY (SEE INSTRUCTIONS, SECTION D)
Choose one (1) of the following periods of validity:
5-year or 10-year
5
ADDITIONAL PERSONAL INFORMATION
Note: If insufficient space, include form PPTC 056, Additional Information – Address and Occupation, available on Canada.ca/passport.
A
Addresses in the last two (2) years
Same as current home address
Different from current home address (complete below)
1.
Number Street Apt.
City
Country Postal/ZIP code
From (YYYY-MM) To (YYYY-MM)
Number
2.
Street Apt. City Country Postal/ZIP code
From (YYYY-MM) To (YYYY-MM)
B
Occupation in the last two (2) years (check all that apply):
I was employed (full- or part-time)
Other, e.g. homemaker, unemployed or retiredI was in school (full- or part-time)
Enter full details below for the last two (2) years:
Employer, school or other Address Telephone (daytime) Field of employment or studies Date (from) Date (to)
6
REFERENCES
Provide the following information for two (2) persons who are not your relatives; are 18 years of age or over; and who have known you for at least
two (2) years. They must agree to have their contact information provided as they may be contacted to confirm your identity. Visit Canada.ca/passport
for more information on the Passport Program's definition of a relative.
1. Surname (last name) Given name(s) Relationship to the applicant
Address
Number Street Apt. City Country Postal/ZIP code
Telephone (daytime) Telephone (other) Email address
Has known
me for
Number of years
2. Surname (last name) Given name(s) Relationship to the applicant
Address
Number Street Apt.
City
Country Postal/ZIP code
Telephone (daytime) Telephone (other) Email address
Has known
me for
Number of years
7
EMERGENCY CONTACT INFORMATION (OPTIONAL)
This information is helpful if you require emergency assistance while outside of Canada.
Surname (last name) Given name(s)
Relationship to the applicant Telephone (daytime) Telephone (other) Email address
Current home address
Number Street Apt. City Country
Postal/ZIP code
Signature of applicant
Date (YYYY-MM-DD)
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Ongoing occupation?
Page 3 of 5
PPTC 482 (02-2021)
ADULT ABROAD SIMPLIFIED RENEWAL PASSPORT APPLICATION
for eligible Canadians applying outside Canada or the USA
INSTRUCTIONS
A
WHO MAY USE THIS FORM?
Important notice: We recommend that you not finalize your travel plans until you receive the
requested passport.
Note: If you cannot answer yes to all of the conditions outlined here, or if this is your first application
for a Canadian passport, you must complete form PPTC 040, Adult Abroad General Passport
Application. Additional documents or information may be requested in support of this application.
You may use this form to renew a passport only if all of the following conditions are met:
• you were at least 16 years of age at the time of your previous application
• the information (name, date of birth, sex and place of birth) requested on this application form is
exactly as it appears on page 2 of the submitted passport and still matches your current information
1
• the Canadian passport being renewed:
• is valid or expired for no more than one (1) year
2
• was or is valid for five (5) years or ten (10) years
3
• is not damaged
• was never reported lost or stolen
B
TRANSLATION
All documents submitted throughout the passport application process that are in a language other than English or French must be translated
by a certified translator.
C
REQUIREMENTS CHECKLIST
Both pages of the application form completed and signed within the last twelve (12) months
Two (2) identical and unaltered passport photos taken within the last six (6) months. No signature is required on the photos
Enclose any Canadian passport issued to you within the last six (6) years
The fee
D
FEE AND PERIOD OF VALIDITY
Where the application is made outside of Canada or the passport is to be delivered outside of Canada:
5-year validity – CAN$190* 10-year validity – CAN$260*
*A CAN$25 consular services fee is included in the above-mentioned fee.
The fee is in Canadian dollars and may be converted to the local currency.
Methods of payment:
Online payment is available for all passport services.
If additional passport services are required (e.g. retention of passport or an additional observation) or if you need to travel in less than
20 business days, please contact the closest Government of Canada Office abroad to confirm eligibility and fees before making payment.
Important
• Every person who requests passport services must pay the applicable fee in the exact amount.
• Applicants who cancel their application or are refused a passport are not eligible for a refund of the passport service fee. Only the consular services
fee of CAN$25, applied only to adult applications, is refundable.
• Administrative fees and applicable interest will be applied to all dishonoured payments.
• Fees are subject to change.
In cases where services do not meet established service standards, applicants may be eligible for partial compensation of service fees.
For information on Service Standards please visit Canada.ca/immigration-refugees-citizenship.
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Page 4 of 5
PPTC 482 (02-2021)
E
WHERE TO APPLY
Submit your application at the nearest Government of Canada office that provides passport services in the country where you reside or are visiting.
You can find a list of Government of Canada offices abroad online at travel.gc.ca or in your local telephone directory.
Offices authorized to process passport applications include:
• Canadian embassies;
• Canadian high commissions; or
• Canadian consulates (except those headed by honorary consuls).
F
CONTACT INFORMATION
General information is available 24 hours a day, 7 days a week. Specific information is available at the nearest Government of Canada office that provides
passport services (consult your local telephone directory).
Information on passports, fees and processing times
Canada.ca/passport Passport Program 1-819-997-8338
TTY (for people who are Deaf or hard of hearing)
Montréal, Canada: 1-514-283-5197
Travel reports, warnings and requirements
For travel advice and warnings or foreign entry and exit requirements (how long the passport has to be valid for travel to a foreign country), visit
travel.gc.ca
G
ANTICIPATED DATE OF TRAVEL
Regardless of the date of travel you indicate on the application form, processing times and requirements for expedited services are still applicable. Processing
times begin once a completed application form, payment and all required supporting documentation are received (see section C). Processing times do not
include mailing time. Visit Canada.ca/passport for more details.
It is recommended that you do not finalize travel plans until you receive the requested passport.
The Government of Canada, or any representative of the Government of Canada will not be liable for any loss incurred as a result of or arising out
of the passport not being delivered in time for you to travel on the date you have specified on the application form.
H
PERSONAL INFORMATION
Surname and given name(s) to appear in passport
Your name must be written exactly as it appears on page 2 of the submitted passport. Your surname (last name) and given name(s) must be spelled the
same and be placed in the same order. If your name has changed, you cannot use this form. You must complete form PPTC 040, Adult Abroad General
Passport Application.
All former surnames
All former surname(s) that differ from the surname requested to appear in the passport, including your surname at birth, must be declared.
Please separate your former surnames by a comma. These former surnames will not appear in the passport.
Mother’s surname at birth
Indicate your mother's surname (last name) at birth.
Place of birth
Your place of birth must be provided on the application form. If you do not wish the place of birth to appear in the passport, complete and submit form
PPTC 077, Request for a Canadian passport without place of birth, available online at Canada.ca/passport.
Date of birth
The specific year, month and day of your birth will be entered as shown on your submitted passport.
Sex
The sex will be entered as shown on the submitted passport. If you request a different sex identifier, you cannot use this form. Visit Canada.ca/passport
for more details.
Signature
You must sign your usual signature on both pages.
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Page 5 of 5
PPTC 482 (02-2021)
I
PREVIOUS CANADIAN PASSPORT
Enclose any Canadian passport issued to you in your current name or any other name that is not expired or is expired for less than one year from the date
you submit your application. If the passport’s expiry date is more than twelve (12) months from the date the application is submitted, provide a written
explanation as to why you are applying at this time. Should the Passport Program not be satisfied that you have an acceptable reason for applying early, your
application for a new passport may be refused.
Note: If the passport has been lost, stolen, damaged or is inaccessible, you cannot use this form.
J
PRIVACY NOTICE STATEMENT
Personal information provided on this form is collected by Immigration, Refugees, and Citizenship Canada (IRCC) under the authority of the Canadian
Passport Order. The personal information provided will be used for the purpose of processing applications, determining entitlement to passport services
and administering passport services. The personal information provided may be disclosed to other federal government institutions, provincial/territorial
governments, foreign governments, investigative bodies and/or law enforcement for the purpose of validating identity, determining current and ongoing
entitlement to passport services and administering or enforcing any law or carrying out a lawful investigation.
Personal information may also be used for purposes including research, statistics, quality assurance, program and policy evaluation, internal audit,
compliance, risk management, strategy development and reporting. Failure to complete the form in full may result in a delay or the application not being
processed. The Privacy Act gives individuals the right of access to, protection, and correction of their personal information. If you are not satisfied with
the manner in which IRCC handles your personal information, you may exercise your right to file a complaint to the Office of the Privacy Commissioner of
Canada. The collection, use, disclosure and retention of your personal information is further described in IRCC’s Personal Information Bank – IRCC PPU 081
and IRCC PPU 082.
K
CANADIAN PASSPORT PHOTO INSTRUCTIONS
You must submit two (2) identical and unaltered photo prints with each passport application. Electronic photos are not acceptable.
More information is available at Canada.ca/passport.
The photos must:
• be taken in person by a commercial photographer;
• be professionally printed on plain, high quality photographic paper
• (photos printed at home are not acceptable);
• be clear, sharp and in focus; in colour or black and white;
• show a neutral facial expression (no smiling, mouth closed) and looking
• straight at the camera, with eyes open and clearly visible;
• have uniform lighting—no shadows, glare or flash reflections;
• show a full front view of the face and top of the shoulders squared to the
• camera (face and shoulders centered in the photo, head not tilted or turned);
• reflect natural skin tone and be taken against a plain white or light coloured
• background with enough contrast between the background, facial features
• and clothing, so that your features appear clearly against the background;
• be originals that have not been altered in any way and not taken from
• an existing photo;
• be taken within the last six (6) months from the date the application
• is submitted and reflect your current appearance.
Frame Height 70 mm (2
3/4
in.)
Minimum Face Height
31 mm (1
1/4
in.)
Maximum Face Height
36 mm (1
7/16
in.)
Frame Width 50 mm (2 in.)
Photo Co. Ltd.
111 Any Street
Any Town, COUNTRY
Photo taken
Date
Not actual size (refer to measurements above)
No signature is required on the photos.
The following must appear on the back of one photo
• The name and complete address of the photo studio (not a P.O. Box) and the date the photo was taken. The photographer may use a stamp or
• handwrite this information (stick-on labels are not acceptable).
• No signature is required on the photos.
Additional information
• Prescription glasses may be worn in photos as long as there is no glare and the eyes are clearly visible.
• The red-eye effect, tinted glasses and sunglasses make the photos unacceptable.
• Hats and head coverings must not be worn, except for religious beliefs or medical reasons. The head covering and hair must not cast shadows
on the face and the full face must be clearly visible.
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Form 1: ADULT ABROAD SIMPLIFIED RENEWAL PASSPORT APPLICATION (Government of Canada)

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Completed 5 November 2021

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