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IMM 5783 (01-2016) E
PROTECTED WHEN COMPLETED - B
VOLUNTARY RENUNCIATION OF PERMANENT RESIDENT STATUS
(DISPONIBLE EN FRANÇAIS - IMM 5783 F)
This document checklist is one of the forms that you need to submit with your application. The documents you need to provide are detailed on this form. Gather
your documents in order of the checklist and check R each item once when they are enclosed.
DO NOT SUBMIT ORIGINALS UNLESS OTHERWISE STATED AS DOCUMENTS SUBMITTED WILL NOT BE RETURNED.
Note that original or certified copies of documents or more information may be requested by an officer at a later date.
You must keep a copy of the completed forms and all documents before sending them to CIC.
Enclose the following items with your application:
1. Your completed and signed Application to Voluntarily Renounce Permanent Resident Status form (IMM 5782).
Note: If the client is under 18 years of age, the form must be signed by either both parents or legal guardians.
2. Use of a Representative form (IMM5476), if applicable.
3. Two (2) photographs that meet the photo specifications (name and date of birth of each applicant must be printed clearly on the
back of one (1) photo).
Please consult “Appendix A - Photo Specifications” in the instruction guide for instructions.
5. Your current valid passport
If you do not have a passport, provide proof of citizenship or permanent resident status in a country other than Canada.
Required documents for clients under 18 years of age
6. A copy of the birth certificate showing the names of both parents.
Note: If the names of both parents do not appear on the birth certificate, include also a baptismal certificate, a civil registry
document, a school transcript or a national identity card which carries the name of the child and both parents.
7. If the child is adopted or under legal guardianship, a copy of the adoption order or legal guardianship documents.
4. Your permanent resident card, if it is still valid. Expired permanent resident cards do not need to be submitted.
Note: If your permanent resident card may still be valid but is lost, stolen or destroyed and you have not previously reported that
loss, theft or destruction to CIC, complete the Solemn declaration concerning a lost, stolen, destroyed or never received
Permanent Resident Card (IMM 5451) form. Submit the IMM 5451 with the application. Do not send the form to the PR
Card Processing Centre.
8. If the child is under the sole custody of one parent, sole custody should be proven by providing:
• The birth certificate which indicates the father is unknown;
• A death certificate of one parent; or
• A court order or a written agreement granting sole custody.
Note: If one parent has custody under a court order or a written agreement which gives the non-custodial parent the right to be
consulted on decisions related to the child, the signatures of both parents are required.