PAGE 1 OF 3
IMM 5526 (12-2016) E
PROTECTED WHEN COMPLETED -
B
(DISPONIBLE EN FRANÇAIS - IMM 5526 F)
SUPPLEMENTARY RELATIONSHIP QUESTIONNAIRE
If you need more space for any of the questions, use another sheet and write the part and question number.
PERSONAL INFORMATION ABOUT SPONSOR
Family name Given name(s)
Date of birth (YYYY-MM-DD)
Client ID (if you know it)
PERSONAL INFORMATION ABOUT SPOUSE OR PARTNER BEING SPONSORED (PRINCIPAL APPLICANT)
Family name Given name(s)
Date of birth (YYYY-MM-DD)
Client ID (if you know it)
PART A - INFORMATION ABOUT THE SPONSOR - TO BE FILLED OUT BY SPONSOR
1. Give the following details for your previous spouses or common-law partners
Family name Given name(s)
Date of birth
(YYYY-MM-DD)
Address
Length of
relationship
Date of divorce/
separation/death
(YYYY-MM-DD)
2. Give the following details for your father and mother
Family name Given name(s)
Date of birth/death
(YYYY-MM-DD)
Address
Father
Mother
3. Did you or any of your family members give your spouse/partner or any of their family members gifts (monetary, material, other, etc.)?
No Yes
If yes, explain.
4. Declaration of sponsor
I declare that the information I have given is truthful, complete and correct.
Sponsor's signature
Date (YYYY-MM-DD)
PAGE 2 OF 3
IMM 5526 (12-2016) E
PART B - INFORMATION ABOUT THE PRINCIPAL APPLICANT - TO BE FILLED OUT BY THE PRINCIPAL APPLICANT
1. Did you (the principal applicant) or any of your family members give your sponsor or their family members gifts (monetary, material, other, etc.)?
No Yes
If yes, explain.
2. Declaration of applicant
I declare that the information I have given is truthful, complete and correct.
Principal applicant's signature
Date (YYYY-MM-DD)
PAGE 3 OF 3
IMM 5526 (12-2016) E
PART C - INFORMATION ABOUT RELATIONSHIP - TO BE FILLED OUT BY THE SPONSOR AND THE PRINCIPAL APPLICANT
1. Describe how your relationship developed after your first contact or meeting and if you dated or went on any outings or trips together. Give details about
your outings and trips.
2. If you are married, who proposed? When and where did the proposal take place?
3. Declaration of sponsor
I declare that the information I have given is truthful, complete and correct.
Sponsor's signature
Date (YYYY-MM-DD)
4. Declaration of applicant
I declare that the information I have given is truthful, complete and correct.
Principal applicant's signature
Date (YYYY-MM-DD)
5. Interpreter Declaration
This section must be fully completed if an interpreter assisted you in the preparation of this form.
I,
, solemnly declare that I have faithfully and accurately interpreted in the
language the content of this application and any related forms to the persons concerned.
I have been informed by the persons concerned, and I do verily believe, that they completely understand the nature and effect of these forms, and I make
this solemn declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath.
Interpreter's
signature
Date (YYYY-MM-DD)
Disclosure
Information provided to Immigration, Refugees and Citizenship Canada (IRCC) is collected under the authority of the Immigration and Refugee Protection Act (IRPA) to determine
admissibility to Canada. Information provided may be shared with other Canadian government institutions such as, but not limited to, the Canada Border Services Agency (CBSA),
the Royal Canadian Mounted Police (RCMP), the Canadian Security Intelligence Service (CSIS), Global Affairs Canada (GAC), Employment and Social Development Canada
(ESDC), Canada Revenue Agency (CRA), provincial and territorial governments and foreign governments in accordance with subsection 8(2) of the Privacy Act. Information may
be disclosed to foreign governments, law enforcement bodies and detaining authorities with respect to the administration and enforcement of immigration legislation where such
sharing of information may not put the individual and or his/her family at risk. Information may also be systematically validated by other Canadian government institutions for the
purposes of validating status and identity to administer their programs.
Depending on the type of application made, the information you provided will be stored in one or more Personal Information Banks (PIB) pursuant to section 10(1) of Canada's
Privacy Act. Individuals also have a right to protection and access to their personal information stored in each corresponding PIB under the Access to Information Act. Further
details on the PIBs pertaining to IRCC's line of business and service and the Government of Canada's access to information and privacy programs are available at the Infosource
website (http://infosource.gc.ca
) and through the IRCC Call Centre. Infosource is also available at public libraries across Canada.