Welcome to the Adult and Child Canadian Passport ......Mailed-in applications are processed in...

Adult and Child Canadian Passport Application Pack for Applicants in the US

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Welcome to the Adult and Child Canadian PassportApplication Pack in the U.S!

This application is both for adults (over 16) and children (under 16) whoare Canadian Citizens applying from the U.S or Bermuda AND who do notqualify for the simplified application process.

How To Use This Kit:

Step 1: Read the instructions provided to you.Step 2: Fill out the Canadian Passport Application form.Step 3: Submit your form with documents and fee.


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Index:

How do I qualify for a Canadian passport in the US 3

Proof of Canadian Citizenship 4

Proof of your ID 5

Photo requirements 6

Provide a guarantor 7

Pay the Fee 8

Where do I apply? 9

Processing time 10

Upon receipt of your Passport 11

Appendix A

Application Form Adult

Appendix B

Application Form Child

Appendix C

Proof of Canadian Citizenship Form PPTC 001

Appendix D

Statutory declaration concerning a lost, stolen, found, damaged orinaccessible passport

Appendix E

Declaration in Lieu of Guarantor form PPTC 132


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How do I qualify for Canadian Passport in the US?

In order to qualify, you need to be an adult (over 16) or child (under 16) tobe able to prove your ID and your Canadian citizenship. You also need topresent two photographs, find a guarantor and pay the appropriate fee. AnyCanadian passport or other travel document issued within the last five (5)years should also be submitted with your application.

Note: If your passport was lost, stolen or is inaccessible to you, please alsofill out Appendix D

Please read on for more detailed information.


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Proof of Canadian Citizenship

You must present an original proof of citizenship. If you were born inCanada, this can be either a Canadian certificate of birth or Certificate ofCanadian citizenship. If you were born outside Canada, you must provideone of the four Canadian citizenship documents below:

Certificate of Canadian citizenshipCertificate of Naturalization in CanadaCertificate of Retention of Canadian citizenshipCertificate of Registration of Birth Abroad

All original documents will be returned to you. Photocopies are notAccepted

Note 1: Since November 26, 2001, only the following identity documentsare accepted as proof of Canadian citizenship for Canadians born in theProvince of Quebec.

a birth certificate issued after January 1, 1994, by le Directeur de l'étatcivil in the Province of Quebeca Certificate of Canadian Citizenship

Since February 2009, Manitoba Division Registrar Certificates nolonger constitute an acceptable proof of Canadian citizenship for passportissuance purposes. Only the following identity documents are accepted asproof of Canadian citizenship for Canadians born in the Province ofManitoba:

a birth certificate issued by the Manitoba Vital Statistics Agencya Certificate of Canadian Citizenship

Note 2: If you were born outside of Canada between February 15, 1977 andApril 16, 1981 inclusively, to a Canadian parent, fill out form PPTC 001included in this application pack.


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Proof of your ID

Additionaly to your Proof of Citizenship, you have to present at least one (1)additional document issued by a federal, provincial or municipal authoritywith your name and signature. For example:

Provincial/state driver's licence Non-driver's licence Provincial/state health care card Other provincial/state identification card Other federal identification card Military identification Certificate of Indian Status Alien Registration Card Old Age Security card Federal, provincial/state or municipal employee identification card Canadian passport

If submitting a photocopy of the document(s), you must photocopy bothfront and back and have the guarantor sign and date every copy.


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Photo Requirements

Please include two (2) identical passport photos taken within the pasttwelve (12) months with your application. These photos must not exceed asize of 50mm wide x 70 mm (2” x 2.75”) long. The name of thephotographer or studio, date, and address along with the guarantor’sstatement must be provided on the backside of one (1) photo. A guarantormust sign the photograph as such: “I certify this to be a true likeness of(your name).”


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Provide a guarantor

A guarantor must be someone who is a Canadian citizen Canadian passportwho has known you for at least two (2) years. Someone whose passport hasbeen expired for less than one-year can still serve as a guarantor. In thecase of a child, have known you (parent or legal guardian) personally forat least two (2) years and have knowledge of the child.

Your guarantor must be at least 18 years of age and must havereceived their passport after turning 16. It is expected that your guarantorshould be able to provide a description of you (physical and historical). Yourguarantor must include his/her passport number in the application, beavailable to Passport Canada for verification and reside in Canada, the USAor Bermuda.

Please note that if you are the parent or legal guardian applyingfor a passport for your child, you cannot act as guarantor.

If you can’t find a guarantor: If you do not know of anyone who meets thecriteria for a guarantor, then the applicant must complete a “Declaration inLieu of Guarantor” form PPTC 132 (Appendix E)

The "Statutory Declaration in Lieu of Guarantor" form must be swornto or declared before, and signed by, a person authorized by law toadminister an oath or a solemn declaration. If completed outside Canada, aqualified official includes a Canadian or British diplomatic or consularrepresentative, or a qualified local official.


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Pay the fee

The fee for the Simplified Canadian Passport Application is $97 for a 24page passport and $102 for a 48 page Passport.

For children under three years old, the 24 page passport fee is $22 and the48 page passport fee is $24.

For children aged 3-15, the fees are $37 and $39 respectively.

We recommend that you request a 48 page passport if you plan to travelabroad extensively. Otherwise just request the 24 page Passport.

If you apply in person, the payment of the fee can be done by cash orcheque, but it is preferred that you pay by credit card or debit card.

If you apply by mail, you should include a money order or certified cheque,or you may input your credit card number in the appropriate place.

Note: The fees are in Canadian dollars. Payment must be made in localcurrency.


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Where do I apply?

1. By Mail: You can send an application to:Foreign Affairs CanadaGatineau, Canada, K1A 0G3.

2. By Courier: You may mail application via courier to:Passport Canada,22 De Varennes Building22 De Varennes StreetGatineau, Quebec, J8T 8R1.

Please be aware that if you mail or courier your kit, currently, the wait timeis approximately four weeks. If you submit it in person, the wait time isabout two weeks.


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Processing Time

Canada Passport Service processing times may change depending on thevolume of applications received and are not guaranteed. Complexity ofroutine verifications and security checks may lead to longer processingtimes. Generally, these are the processing times as of April 2010:

Application submitted in person 2 weeks

Application submitted by mail 4 weeks


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Upon receipt of your Passport

Your passport will be sent to you by mail. Please verify the accuracy of theinformation in the passport, especially your personal information. If thereare any errors, contact Passport Canada immediately.

Signature

You are required to sign your name in ink in the space provided onpage 3.Children 11 years of age or over must sign their own passports.Parents must not sign the passport of a child who cannot sign.

Address

Complete the section provided on page 4.

Contact information

Enter on page 4 the name of a person to be contacted in case of emergencyand keep it up to date. We recommend that you name someone who wouldnot normally travel with you.

ADULT GENERAL PASSPORT APPLICATION for Canadians 16 years of age or over

(in Canada or in the USA)GENERAL INFORMATION

AND INSTRUCTIONSAussi disponible en français

Failure to complete all the required sections of this form will result in your application being rejected.Entitlement to a Canadian Passport

A Canadian passport is the only reliable and universally accepted travel and identification document for Canadians who travel abroad.Issued to Canadian citizens only, a Canadian passport reflects the identity of the applicant as determined by documentary evidence of citizenship and documents to support identity.Children under 16 years of age must have an individual passport (use form PPTC 155 "Child General Passport Application").The bearer of a previous Canadian passport may be eligible to apply for a passport through the simplified renewal process. Consult our website at www.passportcanada.gc.ca.

Requirements Checklist

All THREE (3) pages of the application form completed and signed within the last 12 months.TWO (2) identical passport photos taken within the last 12 months.Application form and one of the photos certified by your guarantor.Proof of Canadian citizenship (no copies or certified copies).Documents to support identity.Any Canadian passport or travel document issued to you within the last FIVE (5) years.The fee.

Additional documents or information may be requested in support of this application.

Applying by MailMailed-in applications are processed in Canada.

BY MAILPassport Canada Foreign Affairs and International Trade Canada Gatineau QC K1A 0G3 CANADA

BY COURIERPassport Canada 22 de Varennes Building 22 de Varennes Street Gatineau QC J8T 8R1 CANADA

DO NOT mail or bring your application to a Canadian government office in the USA. However, passport applications and related forms are available from these offices.

The original documents that you enclose with your application are valuable. To ensure that these documents are not lost or misplaced, it is preferable to use a courier or mail service that allows you to trace your mail.

Applying in PersonFor Canadians living in Canada:

At a Passport Canada service locationAt a participating Canada Post officeAt a participating Service Canada Centre

Our service locations are listed on page 2 of this application and on our website at www.passportcanada.gc.ca.

For Canadians living in the USA:If you require a passport in exceptional circumstances, contact the nearest Canadian government office. Canadian government offices in the USA are listed on page 2 of this application and on our website at www.passportcanada.gc.ca.

This form can only be used to submit an application by mail (see "Applying by mail") or in person at a Passport Canada service location (in Canada).

Processing TimesFor information on the current processing times, visit our website at www.passportcanada.gc.ca or contact us by phone (see "Contact Us", page 2).

Fees

For Canadians living in Canada – C$87 (includes the passport fee (C$62) and consular service fee (C$25))For Canadians living in the USA – C$97 (includes the passport fee (C$72) and consular service fee (C$25))

Note – These fees are subject to change. – Only Canadian funds are accepted.

Important – Every person who requests a passport service must pay the applicable fee. This fee is non-refundable.Preferred method of payment

Debit (Interac) (In person only), orCredit card (Complete section on

application form.)Other acceptable methods of payment

Certified cheque or money order/international money order (postal or bank) payable in Canadian funds to the Receiver General for Canada

Administrative fees and any applicable interest will be applied to all dishonoured payments.

PPTC 153A Page 1 of 4

Contact UsGeneral information is available 24 hours a day, 365 days a year. Specific information is available during regular office hours.INFORMATION ON PASSPORTS AND FEES

Website: www.passportcanada.gc.ca

Toll-free: 1-800-567-6868Outside continental USA: 819-997-8338TTY (For persons who are deaf or hard of hearing)Toll-free: 1-866-255-7655 (7:30 a.m. to 8:00 p.m. ET)

To obtain the most recent version of this form, visit our website.Application forms are also available in Braille, on diskette or in large print for persons with visual impairment.

INFORMATION ON TRAVEL CONDITIONS AND REQUIREMENTSWebsite: www.voyage.gc.ca

Passport Canada Locations (NOT MAILING ADDRESSES)DO NOT mail or use courier services to send your application form directly to a Passport Canada service location in Canada listed below. However, passport applications and related forms are available from these service locations or may be obtained online at www.passportcanada.gc.ca.CANADA

ALBERTACalgary Suite 254 Harry Hays Building 220-4th Avenue South EastCalgary (South) (English only) 14331 Macleod Trail SWEdmonton Suite 126 Canada Place Building 9700 Jasper Avenue

BRITISH COLUMBIARichmond (English only) Suite 310 5611 Cooney RoadSurrey (English only) Suite 900 13401-108th AvenueVancouver Suite 241 Sinclair Centre 757 Hastings Street WestVictoria Bay Centre Level 4 1150 Douglas Street

MANITOBAWinnipeg Suite 400 433 Main Street

NEW BRUNSWICKFredericton Suite 430 Frederick Square 77 Westmorland Street

NEWFOUNDLAND AND LABRADOR

St. John's (English only) Suite 802 TD Place 140 Water Street

NOVA SCOTIAHalifax Suite 1508, 15th Floor Maritime Centre 1505 Barrington Street

ONTARIOBrampton (English only) Suite 401 40 Gillingham DriveHamilton Plaza Level Standard Life Building 120 King Street WestKitchener Mezzanine Level 40 Weber Street EastLondon Suite 201, 2nd Floor 400 York StreetMississauga (English only) Suite 116, 2nd Floor Central Parkway Mall 377 Burnhamthorpe Road East

North York Suite 380, 3rd Floor Joseph Shepard Building 4900 Yonge StreetOttawa Level C, East Tower C.D. Howe Building 240 Sparks StreetScarborough (English only) Suite 210 200 Town Centre CourtSt. Catharines Suite 600 Landmark Building 43 Church StreetThunder Bay 2nd Floor 979 Alloy DriveToronto (English only) Suite 300 74 Victoria StreetWhitby Whitby Mall 1615 Dundas Street EastWindsor Suite 503 CIBC Building 100 Ouellette Avenue

QUEBECGatineau (Hull) Commercial Level 2 Place du Centre 200 Promenade du Portage

Laval Suite 500, 5th Floor 3 Place LavalMontréal West Tower, Suite 103 Complexe Guy-Favreau 200 René-Lévesque Boulevard WestPointe-Claire Suite F-016A Fairview Pointe Claire Shopping Centre 6815 Trans-Canada HighwayQuébec Suite 200, 2nd Floor Place de la Cité, Tour Cominar 2640 Laurier BoulevardSaguenay Suite 408 Immeuble Saint-Michel 3885 Harvey BoulevardSaint-Laurent Suite 112 3300 Boulevard de la Côte-Vertu

SASKATCHEWANRegina Suite 500 1870 Albert StreetSaskatoon Suite 405 Federal Building 101-22nd Street East

All service locations are wheelchair accessible.

USADO NOT mail or bring your application form to a Canadian government office in the USA listed below. However, passport applications and related forms are available from these offices or may be obtained online at www.passportcanada.gc.ca.

ATLANTAThe Consulate General of Canada 100 Colony Square Suite 1700 1175 Peachtree Street NE Atlanta GA

BOSTONThe Consulate General of Canada Three Copley Place Suite 400 Boston MA

BUFFALOThe Consulate General of Canada HSBC Center Suite 3000 Buffalo NY

CHICAGOThe Consulate General of Canada Two Prudential Plaza Suite 2400 180 North Stetson Avenue Chicago IL

DALLASThe Consulate General of Canada Suite 1700 750 North St. Paul Street Dallas TX

DENVERThe Consulate General of Canada Suite 2600 1625 Broadway Denver CO

DETROITThe Consulate General of Canada 600 Renaissance Center Suite 1100 Detroit MI

LOS ANGELESThe Consulate General of Canada 9th Floor 550 South Hope Street Los Angeles CA

MIAMIThe Consulate General of Canada First Union Financial Center Suite 1600 200 South Biscayne Boulevard Miami FL

MINNEAPOLISThe Consulate General of Canada 9th Floor 701 Fourth Avenue South Minneapolis MN

NEW YORKThe Consulate General of Canada 1251 Avenue of the Americas New York NY

SAN FRANCISCOThe Consulate General of Canada 14th Floor 580 California Street San Francisco CA

SAN JUANThe Honorary Consulate of Canada Hato Rey Center Suite 802 268 Ponce de Leon Avenue San Juan PR

SEATTLEThe Consulate General of Canada Suite 600 1501 Fourth Avenue Seattle WA

WASHINGTON D.C.The Embassy of Canada 501 Pennsylvania Avenue NW Washington DC


INSTRUCTIONSPersonal Information1

NAME TO APPEAR IN PASSPORTWrite the name you want to appear in the passport. If this name is different from the name on your documentary evidence of citizenship, the original of the documentation listed below may be required:

– Marriage certificate – Legal change of name (original document from issuing authority)Additional documentation will be required to verify your identity as well as the name to appear in the passport (see instruction no. 5 "Documents to Support Identity").SURNAME (LAST NAME) AT BIRTH/FORMER SURNAME (FORMER LAST NAME)Complete only if different from the surname (last name) to appear in the passport (for Passport Canada information only; will not appear in the passport).PLACE OF BIRTHYour place of birth must be provided on the application form. If you do not wish the place of birth to appear in the passport, submit a written request. Be sure to contact the consulate or embassy of every country you plan to visit to ensure that you will be admitted if the passport does not include your place of birth.SIGNATUREYou MUST sign your usual signature on all THREE (3) pages. Your signature in section 1 will appear in the passport. Therefore, your signature MUST NOT exceed the inner limits of the signature box.

Declaration of Guarantor2A guarantor is a person other than yourself who confirms your identity.Your guarantor:

must be a Canadian citizen 18 years of age or over;must hold a five-year Canadian passport that is valid or has been expired for no more than one year on the day you submit your application;must have been 16 years of age or older when he or she applied for the passport identified in section 2 of this application form;must have known you personally for at least TWO (2) years*;

* To know an applicant personally means that the guarantor is able to confirm aspects of the applicant's personal attributes such as name, approximate age, place of birth, physical description and some personal history such as occupation and place of residence.

must provide the requested information contained in his or her passport;must be accessible to Passport Canada for verification;must reside in Canada, in the USA or in any of the areas where submission of this application form is authorized, e.g. Bermuda. It is not necessary that the guarantor reside in the same country as the applicant.

A family member or person residing at the same address as you may be your guarantor, provided that he or she meets the specified requirements.Your guarantor must perform free of charge the following THREE (3) tasks:1. Complete and sign the "Declaration of Guarantor" section. (Ensure you have completed and signed the form before submitting

it to your guarantor.)2. Write "I certify this to be a true likeness of (your name)" on the back of ONE (1) of your photos, and sign.3. If applicable, sign and date a copy of each document to support your identity (see instruction no. 5 "Documents to Support

Identity").Passport Canada reserves the right to request an alternate guarantor.If you have not known an eligible guarantor for at least TWO (2) years, complete a "Statutory Declaration in Lieu of Guarantor" form PPTC 132, available from any Passport Canada service location in Canada or any Canadian government office in the USA. This form must be completed at your expense before a person authorized by law to administer an oath or solemn affirmation. This may delay the processing time of the passport.

Previous Canadian Passport3

Enclose any Canadian passport or travel document issued to you within the last FIVE (5) years. If your current passport expires more than 12 months from the date you submit your application, provide a written explanation for why you are applying at this time. Should Passport Canada not be satisfied that you have a valid reason for applying early, your application for a new passport may be refused.A person's name may appear in only ONE (1) valid Canadian passport, Certificate of Identity or Travel Document.If the valid passport has been lost, stolen, damaged, destroyed or is inaccessible, complete a "Statutory Declaration" form PPTC 203, available from any Passport Canada service location in Canada, any Canadian government office in the USA or at www.passportcanada.gc.ca. A Canadian passport, once reported lost or stolen, is no longer valid and is not to be used for any travel.


Proof of Canadian Citizenship4Provide ONE (1) of the documents listed in section 4 of the application form (copies or certified copies are not accepted). It will be returned to you. Additional information may be requested to confirm your citizenship. If you are a woman who, before 1947, married a man who was not a British subject, contact Passport Canada.CERTIFICATE OF BIRTH IN CANADAYou may obtain a birth certificate from the Vital Statistics authorities of your province or territory of birth.If you were born in QuebecOnly birth certificates issued on or after January 1, 1994, by the Directeur de l'état civil in the province of Quebec are accepted.CERTIFICATE OF CANADIAN CITIZENSHIPLarge commemorative documents of citizenship issued after February 14, 1977, are not accepted. If you require a certificate of Canadian citizenship, contact:

In Canada, the office of the Registrar of Canadian Citizenship:– Toll-free 1-888-242-2100– TTY (for persons who are deaf or hard of hearing)– Website www.cic.gc.ca

1-888-576-8502 (from 7:00 a.m. to 5:00 p.m. ET)– Citizenship and Immigration Canada www.cic.gc.ca– The nearest Canadian government office.In the USA:

Documents to Support Identity5At least ONE (1) document to support your identity and the name to appear in the passport must be submitted with your application form. Further documentation may be required. Documents to support your identity must be valid, must be issued by a federal, provincial/territorial/state or municipal authority, and must include the bearer's name and signature. For example:

Provincial/territorial/state driver's licenceProvincial health care cardCertificate of Indian Status

Valid Canadian passport or Canadian passport expired for a period of less than one yearUnited States (USA) permanent resident card

Old Age Security card

Other federal, provincial/territorial/state or municipal identification card

Federal, provincial/territorial/state or municipal employee identification card

You may submit original documents. They will be returned to you. If you are submitting copies (both sides), your guarantor must sign and date the copies to indicate that the originals have been seen. If you are submitting copies but are using form PPTC 132, "Statutory Declaration in Lieu of Guarantor", the same official who signs the "Declaration" must also sign and date the copies of the documents you are providing to support your identity to indicate that the originals have been seen. If you have no documents to support your identity, call Passport Canada.

Photo Specifications

IMAGE INFORMATION

Eyes must be open and clearly visible. Glasses, including tinted ones with prescription, may be worn as long as the eyes are clearly visible. Sunglasses are unacceptable.Facial expression must be neutral (not frowning or smiling) with the mouth closed.

Photos must show a full front view of the face with both edges of the face showing clearly. The face and shoulders must be centred in the photo and squared to the camera.

Photos must reflect/represent natural skin tones.The length from chin to crown of head (natural top of head) must be between 31 mm and 36 mm (1 1/4 in. and 1 7/16 in.).

The image must be clear, sharp and in focus.

Photos must be taken with uniform lighting and not show shadows or flash reflection on the face and head. Photos with shadows on the face or background are unacceptable.

Photos must be taken against a plain, uniform, white or light-coloured background.

Hats or head coverings are not permitted except when worn for religious reasons and only if the full facial features are clearly visible.Black and white or colour photos are acceptable.Photos must be originals, not taken from any existing photo, and must have been taken within the last 12 months.

QUANTITY AND FORMATTWO (2) identical unaltered photos produced from the same film or from the same electronic file capturing the digital image.

SIZE AND PAPERThe photos must measure 50 mm X 70 mm in size (2 in. wide x 2 3/4 in. high).Heavy weight paper is unacceptable.Photos must be printed on plain, high quality photographic paper.

PHOTOGRAPHER AND GUARANTORPhotos must be taken by a commercial photographer.The name of the photographer or studio, the address and the date the photo was taken (not the date the photo was printed) must be provided directly on the back of one photo (see illustration).The guarantor must clearly write on the back of ONE (1) photo: "I certify this to be a true likeness of (applicant's name)".

Your passport application will be rejected if your photos do not meet the following specifications:


ADULT GENERAL PASSPORT APPLICATIONfor Canadians 16 years of age or over (in Canada or in the USA)

Protection of InformationPersonal information provided on this application form is protected and used in accordance with the provisions of the Privacy

Act (Personal Information Bank No. FAI PPU 030). This information is collected under the Canadian Passport Order to determine the applicant's current and ongoing entitlement to a Canadian passport, to administer passport services and to provide information to the Consular Affairs Bureau of Foreign Affairs and International Trade Canada in the event that the applicant require assistance while travelling abroad. The information provided, including the applicant's photo, is subject to routine verifications and security queries. To further strengthen Canadian passport security, the photo is stored on an alphanumeric template and incorporated into the passport as a digital image.Passport Canada may use the services of third parties to receive passport applications submitted in person and to process the return of incomplete passport applications. In the performance of these services, personal information will be protected and used in accordance with the provisions of the Privacy Act.Passport Canada may contact the applicant to solicit feedback about passport services.

Helpful Tips for Completing Your Passport ApplicationComplete and sign all THREE (3) pages FAILURE TO COMPLETE ALL THE REQUIRED SECTIONS OF THIS FORM WILL RESULT IN YOUR APPLICATION BEING REJECTED. You must sign your usual signature in the THREE (3)signature blocks provided (one signature per page).Sign within the white box (section 1) Your signature must not touch the shaded border in the signature box on page 1. This signature will appear in the passport. If the signature touches the border, it may be rejected and a new signature will be required which will cause delays.Photos (“General Information and Instructions”, page 4) The finished photos must have a white or light-coloured background and be free of shadows and glare on the face and background. You must have a neutral expression. Your photographer may consult www.passportcanada.gc.ca to access the specifications.Proof of Canadian citizenship (original document) Your original birth certificate or citizenship certificate/card (not a copy) must be submitted. Commemorative certificates are not acceptable. If you were born in the province of Quebec, only birth certificates issued on or after January 1, 1994, by the Directeur de l'état civil are accepted.Complete citizenship information (section 4) All applicants must complete the question: "Did you acquire citizenship of another country before JANUARY 1, 1947?". See the application form, section 4A.Fees (section 6) Submit the correct fee in Canadian funds only. Fill out your credit card information or use a certified cheque or money order/international money order. The preferred method of payment is by debit (Interac) or credit card.Guarantor requirements (section 2) Choose a guarantor who meets the criteria outlined on page 3 of "General Information and Instructions". You must complete your passport application before submitting it to your guarantor. Ensure your guarantor completes and signs section 2 on the application form. Your guarantor must also sign the back of ONE (1) photo and, if applicable, a copy (both sides) of each document to support your identity.

Provide documents to support your identity (ID) (section 5) Provide at least one valid government-issued ID with your name and signature. If you are submitting a copy, both sides must be submitted and signed and dated by your guarantor.References (section 8) Provide TWO (2) references who are not your guarantor or a relative. Friends, co-workers and neighbours may be used as references provided they have known you for at least TWO (2) years.Submit any valid passport or travel document If your passport is still valid when you apply, you must submit it. Any travel document issued in the last FIVE (5) years must be submitted. If your passport has expired, you do not need to submit it.To use your spousal name (section 1) If you want the passport issued in your spousal surname (last name), you must complete the requested information about your marriage, including year of marriage. See the application form, section 1, line 4.Additional Personal Information (section 7)Addresses

Indicate "Same as current address" if your address has not changed in the last TWO (2) years.

OccupationState your occupation over the last TWO (2) years. If you have been a homemaker or retired for the last TWO (2) years, indicate this on the form.

Mother's Maiden NameIndicate your mother's surname (last name) when she was born.

Children's application If applying for a child under 16 years of age, you must use the "Child General Passport Application" form PPTC 155 and, if applicable, ensure that all documents regarding custody or mobility of, or access to the child are submitted.

To avoid delays in issuing the passport, use the Requirements Checklist on page 1 of the "General Information and Instructions" and ensure your application is complete.

Aussi disponible en français PPTC 153

To obtain the most recent version of this form, visit our website at www.passportcanada.gc.ca.

ADULT GENERAL PASSPORT APPLICATION for Canadians 16 years of age or over (in Canada or in the USA)

INFORMATION PROTECTED

WARNING to all applicants and guarantors – Any false or misleading statement on this form or relating to any document in support of this application, including concealment of any material fact, may lead to refusal or revocation of a passport and be grounds for criminal prosecution. Failure to complete all the required sections of this form will result in your application being rejected.

Personal Information1Surname (last name)

Given name(s) (see instruction No. 1)

Surname (last name) at birth (see instruction No. 1) Former surname (former last name) (see instruction No. 1)

If passport requested in spousal surname (last name), enter

Year of marriage Surname (last name) of spouse (see instruction No. 1)

Date of birthYear Month Day

Place of birth

City Country Prov./Ter./State (if applicable)

Sex FemaleMale

Marital status Eye colour Hair colour Height Weight

Address of permanent residence

Number Street Apartment P.O. Box City Prov./Ter./State Postal/Zip code

Mailing address (If different from above)


Daytime telephone number Evening telephone number Cell. number or email address (optional)

DECLARATION – I solemnly declare that I am a Canadian citizen, that the photos enclosed are a true likeness of me and that all of the statements made in this application are true. I declare that I have read and understood the WARNING to all applicants and guarantors above.Date

Year Month DaySigned at

City Province/Territory/State

Date of travel

Unknown

Month Day

Declaration of Guarantor (to be completed by the guarantor only if the applicant has completed and signed this application form)2Surname (last name) Given name(s)


Canadian passport number Date of issueYear Month Day

Date of expiryYear Month Day

Daytime telephone number ( )

Evening telephone number ( )

Surname (last name) in passport, if different


Number Street Apartment City Province/Territory/State Postal/Zip code

DECLARATION – I solemnly declare that I have known the applicant identified above personally for at least TWO (2) years. I have certified on the back of ONE (1) photo that the image is a true likeness of the applicant. If applicable, I have signed a copy of each document to support the applicant's identity confirming that I have seen the original(s). I declare that I have read and understood the WARNING to all applicants and guarantors above.

I have known the applicant for

Number of years Signature of guarantorDate


Province/Territory/StateCity Aussi disponible en français PPTC 153 Page 1 of 3

Previous Canadian Passport3Enclose any Canadian passport or travel document issued to you within the last FIVE (5) years.Would you like the passport to be returned to you? YesNoIf the passport issued to you in the last FIVE (5) years has been lost, stolen, damaged, destroyed or is inaccessible, you must include with this application form a completed "Statutory Declaration" form PPTC 203, available from any Passport Canada service location in Canada, any Canadian government office in the USA or at www.passportcanada.gc.ca.

Proof of Canadian Citizenship4A To be completed by ALL applicants. Did you acquire citizenship of another country before JANUARY 1, 1947?

No Yes (specify)By birthBy naturalization

Country Effective dateYear Month Day

B To be completed if you were born in Canada. Provide ONE (1) of the two documents listed below (no copies):

Birth certificate in Canada (see instruction No. 4)

Certificate of Canadian citizenship (see instruction No. 4)

Registration number Date of issue

Certificate number Date of issue

C To be completed if you were born outside of Canada.1) Provide ONE (1) of the four documents listed below (no copies):

Certificate of Canadian citizenship (see instruction No. 4)

Certificate of naturalization

Certificate of registration of birth abroad (issued by the Registrar of Canadian Citizenship)Certificate of retention of Canadian citizenship (issued before February 15, 1977)


2) To be completed if you were born outside of Canada between February 15, 1977 and April 16, 1981 inclusively. (You do not need to complete this section if you are presenting a certificate of Canadian citizenship issued after January 1, 2007.)a) Are you a naturalized Canadian? (i.e. Did you receive

Canadian citizenship following immigration to Canada?)Yes - Go to section 5 No - Continue to question b)

b) Was one of your parents born in Canada? Yes - Go to section 5 No - Continue to c)c) Complete and submit form PPTC 001 "Proof of Canadian Citizenship – Additional Information" which you can obtain at

www.passportcanada.gc.ca or at any Passport Canada service location, participating Canada Post office, participating Service Canada Centre in Canada or any Canadian government office in the USA.

Documents to Support Identity5Provide the following information. Include signed copies (both sides) or original documents (see instruction No. 5).

Type of document Document number Date of expiry (if applicable)Year Month Day

Name of bearer as it appears on the document

Type of document Document number Date of expiry (if applicable)Year Month Day

Name of bearer as it appears on the document

Declaration of ApplicantDECLARATION – I solemnly declare that the statements made in this application are true.Signature of applicant Date



Credit Card Information6COMPLETE ONLY if you are not appearing in person and you wish to pay by credit card.

Name appearing on card

Card number Date of expiryMonth Year

AUTHORIZATION – I authorize Passport Canada to chargeC$ to my credit card.

Signature of cardholder DateYear Month Day

FOR OFFICIAL USE ONLY

Authorization number

PPTC 153 Page 2 of 3

Additional Personal Information7A Addresses in the last TWO (2) years Same as current address.

Addresses in the last TWO (2) years if different from current address. (If insufficient space, attach a separate sheet.)(Number, Street, Apartment, City, Province/Territory/State, Country)

1.

FromYear Month

ToYear Month

2.From Year Month To Year Month

B Occupation in the last TWO (2) years (If insufficient space, attach a separate sheet. If you are, for example, a homemaker or are retired, indicate this in the "Employer/school or other" column.)In the last TWO (2) years, my employers were and/or I was attending educational institutions as follows:

Employer/school or other Address Daytime phone Nature of employment/studies Date (From) Date (To)

CMother's maiden name

Provide your mother's surname (last name) at the time of her birth.

References8Provide the following information with respect to TWO (2) persons who are neither your relatives nor your guarantor and who have known you for at least TWO (2) years. They may be contacted to confirm your identity.

1. Surname (last name) Given name(s)

Relationship Address (Number, Street, Apartment, City, Province/Territory/State, Country)

Daytime phone Evening phone Cell. number or email address (optional) Has known me for

State number of years

2. Surname (last name) Given name(s)

Relationship Address (Number, Street, Apartment, City, Province/Territory/State, Country)

Daytime phone Evening phone Cell. number or email address (optional) Has known me for

State number of years

Emergency Contact (optional)9We recommend that you provide the name of someone who would not normally travel with you. This information is helpful if you have an accident or become ill while travelling outside of Canada.

Surname (last name) Given name(s)

Relationship to applicant Daytime phone Evening phone Cell. number

Address

Number Street Apartment City Prov./Ter./State Postal/Zip code

Declaration of ApplicantDECLARATION – I solemnly declare that the statements made in this application are true.

Signature of applicant DateYear Month Day

Signed at

City Province/Territory/StatePPTC 153 Page 3 of 3

CHILD GENERAL PASSPORT APPLICATION for Canadians under 16 years of age (in Canada or in the USA)

GENERAL INFORMATION AND INSTRUCTIONSAussi disponible en français

Failure to complete all the required sections of this form will result in your application being rejected.Entitlement to a Canadian Passport

A Canadian passport is the only reliable and universally accepted travel and identification document for Canadians who travel abroad.Canadian passports are issued to Canadian citizens only.If applying for an individual passport for a child under 16 years of age, use this application form (PPTC 155) to apply.

Who May Apply for a Passport on Behalf of a Child?One of the parents;The custodial parent in cases of separation or divorce; orThe legal guardian.

Requirements Checklist

BOTH pages of the application form completed and signed within the last 12 months.TWO (2) identical passport photos of the child (see "Photo Specifications").Application form and one of the photos certified by your guarantor.Proof of Canadian citizenship (no copies or certified copies).

All documents that refer to custody or mobility of, or access to, the child.

Any valid Canadian passport or travel document issued to the child.

The fee.Additional documents or information may be requested in support of this application.

Periods of Validity for Passports Issued to ChildrenFor a child aged:

3 to 15 years, the maximum period of validity is 5 years.under 3 years, the maximum period of validity is 3 years.

Note: Children who have been issued a passport in their first 12 months may be issued a one-time replacement passport, free of charge, valid for the balance of the three-year validity period of the original passport. Full application requirements must be met. To ensure the photo is a current and true likeness of the child, it must be taken within one month of the date the application is submitted.

Processing TimesFor information on current processing times, visit our website at www.passportcanada.gc.ca or contact us by phone (see "Contact Us", page 2).

Applying by Mail

Mailed-in applications are processed in Canada.

BY MAILPassport Canada Foreign Affairs and International Trade Canada Gatineau QC K1A 0G3 CANADA

BY COURIERPassport Canada 22 de Varennes Building 22 de Varennes Street Gatineau QC J8T 8R1 CANADA

DO NOT mail or bring your application to a Canadian government office in the USA. However, passport applications and related forms are available from these offices.The original documents that you enclose with your application are valuable. To ensure that these documents are not lost or misplaced, it is preferable to use a courier or mail service that allows you to trace your mail.

Applying in Person

For Canadians living in Canada:At a Passport Canada service locationAt a participating Canada Post officeAt a participating Service Canada Centre

Our service locations are listed on page 2 of this application and on our website at www.passportcanada.gc.ca.

For Canadians living in the USA:If the child requires a passport in exceptional circumstances, contact the nearest Canadian government office. Canadian government offices in the USA are listed on page 2 of this application and on our website at www.passportcanada.gc.ca.

This form can only be used to submit an application by mail (see "Applying by mail") or in person at a Passport Canada service location (in Canada).

FeesFor a child aged – 3 to 15 years – C$37

– under 3 years – C$22Note – These fees are subject to change.

– Only Canadian funds are accepted.Important – Every person who requests a passport service must pay the applicable fee. This fee is non-refundable.Preferred method of payment

Debit (Interac) (In person only), orCredit card (Complete section on

application form.)Other acceptable methods of payment

Certified cheque or money order/international money order (postal or bank) payable in Canadian funds to the Receiver General for Canada

Administrative fees and any applicable interest will be applied to all dishonoured payments.


Contact UsGeneral information is available 24 hours a day, 365 days a year. Specific information is available during regular office hours.INFORMATION ON PASSPORTS AND FEES

Website: www.passportcanada.gc.ca

Toll-free: 1-800-567-6868Outside continental USA: 819-997-8338TTY (For persons who are deaf or hard of hearing)Toll-free: 1-866-255-7655 (7:30 a.m. to 8:00 p.m. ET)

To obtain the most recent version of this form, visit our website.Application forms are also available in Braille, on diskette or in large print for persons with visual impairment.

INFORMATION ON TRAVEL CONDITIONS AND REQUIREMENTSWebsite: www.voyage.gc.ca

Passport Canada Locations (NOT MAILING ADDRESSES)DO NOT mail or use courier services to send your application form directly to a Passport Canada service location in Canada listed below. However, passport applications and related forms are available from these service locations or may be obtained online at www.passportcanada.gc.ca.CANADA

ALBERTACalgary Suite 254 Harry Hays Building 220-4th Avenue South EastCalgary (South) (English only) 14331 Macleod Trail SWEdmonton Suite 126 Canada Place Building 9700 Jasper Avenue

BRITISH COLUMBIARichmond (English only) Suite 310 5611 Cooney RoadSurrey (English only) Suite 900 13401-108th AvenueVancouver Suite 241 Sinclair Centre 757 Hastings Street WestVictoria Bay Centre Level 4 1150 Douglas Street

MANITOBAWinnipeg Suite 400 433 Main Street

NEW BRUNSWICKFredericton Suite 430 Frederick Square 77 Westmorland Street

NEWFOUNDLAND AND LABRADOR

St. John's (English only) Suite 802 TD Place 140 Water Street

NOVA SCOTIAHalifax Suite 1508, 15th Floor Maritime Centre 1505 Barrington Street

ONTARIOBrampton (English only) Suite 401 40 Gillingham DriveHamilton Plaza Level Standard Life Building 120 King Street WestKitchener Mezzanine Level 40 Weber Street EastLondon Suite 201, 2nd Floor 400 York StreetMississauga (English only) Suite 116, 2nd Floor Central Parkway Mall 377 Burnhamthorpe Road East

North York Suite 380, 3rd Floor Joseph Shepard Building 4900 Yonge StreetOttawa Level C, East Tower C.D. Howe Building 240 Sparks StreetScarborough (English only) Suite 210 200 Town Centre CourtSt. Catharines Suite 600 Landmark Building 43 Church StreetThunder Bay 2nd Floor 979 Alloy DriveToronto (English only) Suite 300 74 Victoria StreetWhitby Whitby Mall 1615 Dundas Street EastWindsor Suite 503 CIBC Building 100 Ouellette Avenue

QUEBECGatineau (Hull) Commercial Level 2 Place du Centre 200 Promenade du Portage

Laval Suite 500, 5th Floor 3 Place LavalMontréal West Tower, Suite 103 Complexe Guy-Favreau 200 René-Lévesque Boulevard WestPointe-Claire Suite F-016A Fairview Pointe Claire Shopping Centre 6815 Trans-Canada HighwayQuébec Suite 200, 2nd Floor Place de la Cité, Tour Cominar 2640 Laurier BoulevardSaguenay Suite 408 Immeuble Saint-Michel 3885 Harvey BoulevardSaint-Laurent Suite 112 3300 Boulevard de la Côte-Vertu

SASKATCHEWANRegina Suite 500 1870 Albert StreetSaskatoon Suite 405 Federal Building 101-22nd Street East

All service locations are wheelchair accessible.

USADO NOT mail or bring your application form to a Canadian government office in the USA listed below. However, passport applications and related forms are available from these offices or may be obtained online at www.passportcanada.gc.ca.

ATLANTAThe Consulate General of Canada 100 Colony Square Suite 1700 1175 Peachtree Street NE Atlanta GA

BOSTONThe Consulate General of Canada Three Copley Place Suite 400 Boston MA

BUFFALOThe Consulate General of Canada HSBC Center Suite 3000 Buffalo NY

CHICAGOThe Consulate General of Canada Two Prudential Plaza Suite 2400 180 North Stetson Avenue Chicago IL

DALLASThe Consulate General of Canada Suite 1700 750 North St. Paul Street Dallas TX

DENVERThe Consulate General of Canada Suite 2600 1625 Broadway Denver CO

DETROITThe Consulate General of Canada 600 Renaissance Center Suite 1100 Detroit MI

LOS ANGELESThe Consulate General of Canada 9th Floor 550 South Hope Street Los Angeles CA

MIAMIThe Consulate General of Canada First Union Financial Center Suite 1600 200 South Biscayne Boulevard Miami FL

MINNEAPOLISThe Consulate General of Canada 9th Floor 701 Fourth Avenue South Minneapolis MN

NEW YORKThe Consulate General of Canada 1251 Avenue of the Americas New York NY

SAN FRANCISCOThe Consulate General of Canada 14th Floor 580 California Street San Francisco CA

SAN JUANThe Honorary Consulate of Canada Hato Rey Center Suite 802 268 Ponce de Leon Avenue San Juan PR

SEATTLEThe Consulate General of Canada Suite 600 1501 Fourth Avenue Seattle WA

WASHINGTON D.C.The Embassy of Canada 501 Pennsylvania Avenue NW Washington DC


INSTRUCTIONSChild's Personal Information1

NAME TO APPEAR IN PASSPORTWrite the child's name as you want it to appear in the passport. If this name is different from the name on the child's documentary evidence of citizenship, the child's legal change of name document (original document from issuing authority) may be required. Additional documents may be requested to verify the child's identity.SURNAME (LAST NAME) AT BIRTH/FORMER SURNAME (FORMER LAST NAME)Complete only if different from the surname (last name) to appear in the passport (for Passport Canada information only; will not appear in the passport).PLACE OF BIRTHThe place of birth must be provided on the application form. If you do not wish the place of birth to appear in the passport, submit a written request. Be sure to contact the consulate or embassy of every country you plan to visit to ensure that the child will be admitted if the passport does not include the place of birth.SIGNATUREChildren 11 years of age or over MUST sign their usual signature. The child's signature in section 1 will appear in the passport. Therefore, the signature MUST NOT exceed the inner limits of the signature box.

Information on Applicant2

Both parents are requested to participate in obtaining passport services for their child and to sign the application form. The other parent may be contacted. To avoid possible delays, we strongly recommend that you provide a long-form birth certificate showing information on both parents. Where a legal guardian is the applicant, the other legal guardian as the case may be is also requested to participate.CUSTODY, SEPARATION AND DIVORCEWhere a court order or agreement exists referring to custody of the child, only the person with custodial rights may apply. All documents that refer to custody or mobility of, or access to, the child must be provided. If a divorce has been granted, a copy of the divorce judgement or order must also be provided. Where joint custody provisions exist, either parent may apply.

RELATIONSHIP WITH OTHER PARENTIndicate your current relationship with the other parent: single, common law, married, separated, divorced, widowed. Indicate date of marriage to the other parent, if applicable. Additional information or documentation may be requested.For further information, contact Passport Canada.


Enclose any valid Canadian passport or travel document issued to the child. If the child's current passport expires more than 12 months from the date of submission of the application, provide a written explanation for why you are applying at this time. Should Passport Canada not be satisfied that you have a valid reason for applying early, your application for a new passport may be refused.If the valid passport has been lost, stolen, damaged, destroyed or is inaccessible, complete a "Statutory Declaration" form PPTC 203, available from any Passport Canada service location in Canada, any Canadian government office in the USA or at www.passportcanada.gc.ca. A Canadian passport, once reported lost or stolen, is no longer valid and is not to be used for any travel.

Proof of Canadian Citizenship4

Provide ONE (1) of the documents listed in section 4 of the application form (copies or certified copies are not accepted). It will be returned to you. Additional information may be requested to confirm the child's citizenship.CERTIFICATE OF BIRTH IN CANADAA birth certificate may be obtained from the Vital Statistics authorities of the child's province or territory of birth. To avoid possible delays, we strongly recommend that you provide a long-form birth certificate showing information on both parents.If the child was born in QuebecOnly birth certificates issued on or after January 1, 1994, by the Directeur de l'état civil in the province of Quebec are accepted.CERTIFICATE OF CANADIAN CITIZENSHIPLarge commemorative documents of citizenship issued after February 14, 1977, are not accepted. If the child requires a certificate of Canadian citizenship, contact:

In Canada, the office of the Registrar of Canadian Citizenship:– Toll-free 1-888-242-2100– TTY (for persons who are deaf or hard of hearing) 1-888-576-8502 (from 7:00 a.m. to 5:00 p.m. ET)– Website www.cic.gc.ca

In the USA:– The nearest Canadian government office.– Citizenship and Immigration Canada www.cic.gc.ca


Declaration of Guarantor5

A guarantor is a person other than the applicant who confirms the applicant's identity and has knowledge of the child.Your guarantor:

must be a Canadian citizen 18 years of age or older;must hold a five-year Canadian passport that is valid or has been expired for no more than one year on the day you submit your application;must have been 16 years of age or older when he or she applied for the passport identified in section 5 of this application form;must have known you (the applicant) personally for at least TWO (2) years*;

* To know an applicant personally means that the guarantor is able to confirm aspects of the applicant's personal attributes such as name, approximate age, place of birth, physical description and some personal history such as occupation and place of residence.

must provide the requested information contained in his or her passport;must be accessible to Passport Canada for verification;must reside in Canada, in the USA or in any of the areas where submission of this application form is authorized, e.g. Bermuda. It is not necessary that the guarantor reside in the same country as the applicant.

A family member or person residing at the same address as you (the applicant) may be your guarantor, provided that he or she meets the specified requirements. If you are the parent or legal guardian applying for a passport for the child, you cannot sign as guarantor. However, if applicable, the other parent or legal guardian of the child may sign.Your guarantor must perform free of charge the following TWO (2) tasks:1. Complete and sign the "Declaration of Guarantor" section. (Ensure you have completed and signed the form before submitting

it to your guarantor.)2. Write "I certify this to be a true likeness of (child's name)" on the back of ONE (1) of the child's photos, and sign.Passport Canada reserves the right to request an alternate guarantor.If you have not known an eligible guarantor for at least TWO (2) years, complete a "Statutory Declaration in Lieu of Guarantor" form PPTC 132, available from any Passport Canada service location in Canada or any Canadian government office in the USA. This form must be completed at your expense before a person authorized by law to administer an oath or solemn affirmation. This may delay the processing time of the passport.

Photo SpecificationsYour passport application will be rejected if the photo of the child do not meet the following specifications:

IMAGE INFORMATIONOnly the head and shoulders of young children must appear on the photo (e.g. no hands holding the child).Photos must be taken with uniform lighting and not show shadows or flash reflection on the face and head. Photos with shadows on the face or background are unacceptable.Photos must show a full front view of the face with both edges of the face showing clearly. The face and shoulders must be centred in the photo and squared to the camera.Eyes must be open and clearly visible. Glasses, including tinted ones with prescription, may be worn as long as the eyes are clearly visible. Sunglasses are unacceptable.Facial expression must be neutral (not frowning or smiling) with the mouth closed.The image must be clear, sharp and in focus.Photos must be taken against a plain, uniform, white or light-coloured background.Photos must reflect/represent natural skin tones.The length from chin to crown of head (natural top of head) must be between 31 mm and 36 mm (1 1/4 in. and 1 7/16 in.).Hats or head coverings are not permitted except when worn for religious reasons and only if the full facial features are clearly visible.Black and white or colour photos are acceptable.Photos must be originals, not taken from any existing photo, and have been taken within the last 12 months or if applying for a one-time replacement passport, taken within the last month.

QUANTITY AND FORMATTWO (2) identical unaltered photos produced from the same film or from the same electronic file capturing the digital image.

SIZE AND PAPERThe photos must measure 50 mm x 70 mm in size (2 in. wide x 2 3/4 in. high).Heavy weight paper is unacceptable.Photos must be printed on plain, high quality photographic paper.

PHOTOGRAPHER AND GUARANTORPhotos must be taken by a commercial photographer.The name of the photographer or studio, the address and the date the photo was taken (not the date the photo was printed) must be provided directly on the back of one photo (see illustration).The guarantor must clearly write on the back of ONE (1) photo: "I certify this to be a true likeness of (child's name)".


PPTC 155

IMPORTANT INFORMATION CONCERNING CHILDREN TRAVELLING ABROADTravelling with Children or Children Travelling Alone

Immigration authorities in most countries are becoming increasingly vigilant when children are crossing international borders. Whether travelling alone or accompanied by an adult, each child travelling abroad must have a valid passport and may also require supporting documentation. Prior to any travel that includes a child, you should contact the embassy or consulate of all countries the child will be visiting to inquire about entry requirements.

Documentation to Facilitate Travel AbroadThe following documents may be required to support the entry of a child to another country:

Birth certificate showing the names of both parentsDocuments pertaining to custodyIf the child is travelling with one parent, a letter signed and dated from the other parent authorizing travel (letter may have to be notarized)If the child is travelling with someone other than the parent, a letter signed and dated from both parents authorizing travel with that person (letter may have to be notarized)If the child is travelling alone, a letter signed and dated from both parents authorizing travel (letter may have to be notarized)If one of the parents is deceased, the death certificate

Documentation and Tips to Facilitate the Return to CanadaThe following tips may help to avoid delays when a child is returning to Canada:

Always carry proper identification for yourself and the child – passport, birth certificate, citizenship card, Record of Landing (IMM 1000), permanent resident card or Indian Status Card.If you have custody of the child, carry copies of documents specifying custody rights with you .If you are not the legal guardian of the child, carry a letter of permission or authorization for you to have custody when entering Canada. When a parent is travelling alone with a child, a letter from the other parent can also facilitate the return of both the parent and the child. The letter should also contain telephone numbers where the parent or legal guardian can be contacted.If you are travelling as part of a caravan, ensure you are in the same vehicle as the child you are accompanying when arriving at a border crossing.Have the child memorize your home and/or office telephone number and teach him or her to call you in an emergency.

Custody Information1. Custody arrangements in Canada may not be recognized in another country. In extreme cases, the child may not be able to leave

the country visited. It is recommended that, before leaving on a trip, you check with the embassy or consulate of the country or countries the child will be visiting to determine what documentation may be required relating to the custody of the child.For further information, contact:

Foreign Affairs and International Trade Canada:In Canada 1-800-387-3124Outside Canada 613-943-1055

2. If a custody dispute could possibly arise while travelling with the child, you should talk to a Canadian lawyer prior to your departure. We suggest you also read the publication, International Child Abductions: A Manual for Parents.For a free copy, call:

In Canada 1-800-267-8376Outside Canada 613-944-4000

You may also order a copy online or access an online version:Website www.international.gc.ca

Protection of InformationPersonal information provided on this application form is protected and used in accordance with the provisions of the Privacy Act (Personal Information Bank No. FAI PPU 030). This information is collected under the Canadian Passport Order to determine the current and ongoing entitlement of the child to a Canadian passport, to administer passport services and to

provide information to the Consular Affairs Bureau of Foreign Affairs and International Trade Canada in the event that the child requires assistance while travelling abroad. The information provided, including the child's photo, is subject to routine verifications and security queries. To further strengthen Canadian passport security, the photo is stored on an alphanumeric template and incorporated into the passport as a digital image.Passport Canada may use the services of third parties to receive passport applications submitted in person and to process the return of incomplete passport applications. In the performance of these services, personal information will be protected and used in accordance with the provisions of the Privacy Act.Passport Canada may contact the applicant to solicit feedback about passport services.

CHILD GENERAL PASSPORT APPLICATION for Canadians under 16 years of age (in Canada or in the USA)

INFORMATION PROTECTED

WARNING to all applicants and guarantors – Any false or misleading statement on this form or relating to any document in support of this application including concealment of any material fact, may lead to refusal or revocation of a passport and be grounds for criminal prosecution. Failure to complete all the required sections of this form will result in your application being rejected.

Child's Personal Information1Surname (last name)

Given name(s) (see instruction No. 1)

Surname (last name) at birth/former surname (former last name) (see instruction No. 1)


Place of birth

City Country Prov./Ter./State (if applicable)

SexFemale Male

Eye colour Hair colour Height Weight



Mailing address (If different from above)


Children 11 years of age or over must sign in the signature block.

DateYear Month Day

Signed at


Information on Applicant2Is the child the subject of an adoption process? No YesAre there any separation agreements, court orders or legal proceedings pertaining to custody or mobility of, or access to the child?

No Yes

If yes, include all documents (see instruction No. 2)

Applicant (parent or legal guardian)Surname (last name) at birth

Given name(s)


Country

Relationship with other parent Date of marriage (if applicable)Year Month Day

Address (Number, Street, Apartment, City, Province/Territory/State, Postal/Zip code)

Daytime phone Evening phone Cell. number (optional)

DECLARATION – I solemnly declare that the child named above is a Canadian citizen, that I am the parent or legal guardian of the child named above and that the statements made in this application are true. I declare that I have read and understood the WARNING to all applicants and guarantors above.

Signature of applicant (also sign section 4) Date Signed at

Other parent or legal guardianSurname (last name) at birth

Given name(s)


Country

Relationship with parent applying Date of marriage (if applicable)Year Month Day

Address (Number, Street, Apartment, City, Province/Territory/State, Postal/Zip code)

Daytime phone Evening phone Cell. number (optional)

DECLARATION – I solemnly declare that the child named above is a Canadian citizen, that I am the parent or legal guardian of the child named above and that the statements made in this application are true. I declare that I have read and understood the WARNING to all applicants and guarantors above.

Signature of other parent or legal guardian Date Signed at

Date of Travel

Unknown

Month Day

Aussi disponible en français PPTC 155 Page 1 of 2


Enclose any valid Canadian passport or travel document issued to the child. If the passport has been lost, stolen, damaged, destroyed or is inaccessible, you must include with this application form a completed "Statutory Declaration" form PPTC 203, available from any Passport Canada service location in Canada, any Canadian government office in the USA or at www.passportcanada.gc.ca.

Proof of Canadian Citizenship4A To be completed if the child was born in Canada. Provide ONE (1) of the two documents listed below (no copies):

Birth certificate in Canada

Certificate of Canadian citizenship

Registration number Date of issue


B To be completed if the child was born outside of Canada. Provide the following document (no copies):

Certificate of Canadian citizenship Certificate number Date of issue

Declaration of ApplicantSurname (last name) of applicant (see General Information and Instructions, page 1 "Who May Apply for a Passport on Behalf of a Child?")

Given name(s) of applicant

Relationship to child Surname (last name) of child Given name(s) of child

DECLARATION – I solemnly declare that the child named herein is a Canadian citizen, that the photos enclosed are a true likeness of the child and that the statements made in this application are true. I declare that I have read and understood the WARNING to all applicants and guarantors on page 1.

DateYear Month Day

Signed at


Declaration of Guarantor (to be completed by the guarantor only if the applicant has completed and signed this application form)5Surname (last name) Given name(s)


Canadian passport number Date of issueYear Month Day

Date of expiryYear Month Day

Daytime telephone number

( )

Evening telephone number

( )

Surname (last name) in passport, if different


Number Street City Province/Territory/State Postal/Zip code

DECLARATION – I solemnly declare that I have known the applicant identified above personally for at least TWO (2) years. I have certified on the back of ONE (1) photo that the image is a true likeness of the child. I declare that I have read and understood the WARNING to all applicants and guarantors on page 1.

I have known the applicant for

Number of years Signature of guarantorName of applicant Name of child Date



Apartment

Credit Card Information6COMPLETE ONLY if you are not appearing in person and you wish to pay by credit card.

Name appearing on card

Card number Date of expiryMonth Year

AUTHORIZATION – I authorize Passport Canada to chargeC$ to my credit card.

Signature of cardholder DateYear Month Day

FOR OFFICIAL USE ONLY

Authorization number

PPTC 155 Page 2 of 2

STATUTORY DECLARATIONconcerning a lost, stolen, damaged, destroyed or

inaccessible Canadian passport or travel document

Print in block letters using black or dark blue ink

INFORMATIONPROTECTED

Applicant’s Personal Information

Declaration of Applicant

)s(emaN neviGemanruS

1. I hereby declare that

2. I have made the following efforts to locate this document:

3. This document was last seen or used

This form must be completed before, and signed by, a qualified official who has the authority to administer an oath or solemn declaration (e.g. acommissioner for oaths, notary public, lawyer, etc.). If completed outside Canada, a qualified official includes a Canadian or British diplomatic orconsular representative, or a qualified local official.

DECLARATION - I solemnly declare that, to my knowledge, thestatements made in this declaration are true.

4. Should I ever regain possession of the above original document, I promise to return it immediately to Passport Canada, or, if Iam abroad, to the nearest Canadian government office. I acknowledge that a Canadian passport, once reported lostor stolen, is no longer valid and is not to be used for any travel.

, number

name,

or inaccessible on

, on at

at

under the following circumstances (full and detailed information must be provided below):

becamelost

damaged

stolen

destroyed

, issued in my name or my child’s

Date of Birth Place of BirthYear Month Day

Year Month Day

yrtnuoC)elbacilppa fi( yrotirreT/ecnivorPytiC

yrotirreT/ecnivorPytiC Signature

Français au verso

Document NumberType of Document

Child’s Name Year Month Day

Year Month Day City (Exact location)

Place of issue

Year Month Day

Police Report Filed No Yes (Specify) Date of Report

ta dengiSetaD

Declaration of Official)s(emaN neviGemanruS

As

Address

Business Telephone Number/Extension

DateDECLARATION made before me on

( ) ( )Home Telephone Number

Signed at

Fax Number or E-Mail Address (Optional)

Commissioner for Oaths Lawyer Notary Public Other qualified official (Specify)

yrotirreT/ecnivorPytiCteertSrebmuN Appartment Postal Code

Year Month Day

yrotirreT/ecnivorPytiC Signature of Official

No.

PP

TC

203 (09-04)

Date appliedYear Month Day

PROOF OF CANADIAN CITIZENSHIP – ADDITIONAL INFORMATION

This form must be completed by those born outside of Canada between February 15, 1977 and April 16, 1981inclusively, to a Canadian parent. It must be fully completed, signed and submitted with your passport application.

You do NOT need to complete this form if:• you are presenting a certificate of Canadian citizenship issued after January 1, 2007; OR• one of your parents was born in Canada; OR• you received Canadian citizenship after being adopted by a Canadian parent.

PRINT OR TYPE IN CAPITAL LETTERS using black or dark blue ink

INFORMATIONPROTECTED

WARNING – Any false or misleading statement on this form or relating to any document in support of your application, includingconcealment of any material fact, may lead to refusal or revocation of a passport and be grounds for criminal prosecution.

Applicant’s Personal InformationSurname (last name)

DECLARATION – I solemnly declare that the information provided on this form istrue, correct and complete, and I give my consent to Citizenship and ImmigrationCanada to provide confidential citizenship status information concerning me toPassport Canada. I declare that I have read and understood the WARNING above.

Name as it appears on the certificate of Canadian citizenship, if different

Date of birth Place of birthYear

Surname (last name) Given name(s)

Month DayCity Province/territory/state (if applicable)

City Province/territory/state Signature

Françaisau

versoP

PT

C001

(09-04)

Country

Given name(s)

Date Signed atYear Month Day

Additional Information on Canadian CitizenshipIf you do not know the answers to the following questions, contact Citizenship and Immigration Canada at 1-888-242-2100 (in Canadaonly) or visit their website at www.cic.gc.ca.

1. Before you were born, was one of your parents granted Canadian citizenship following immigration � No � Yesto canada?

2. Was one of your Canadian parents born outside Canada before February 15, 1977, AND was his or her birth � No � Yesabroad registered with Canadian Citizenship and Immigration authorities before February 15, 1977?

complete and sign the declaration below and attach the present form to your passport application.

proceed to questions 3 and 4.

If you answered No to questions 3 AND 4,

If you answered Yes to question 3 OR 4,

3. Is one of your parents a Canadian citizen because he or she was born outside Canada between � No � YesJanuary 1, 1947, and February 14, 1977 (inclusively) AND, although eligible to be registered as a Canadiancitizen at birth, was not registered until after February 14, 1977?

4. Is one of your parents a Canadian citizen because he or she was born outside Canada after � No � YesFebruary 14, 1977, to a Canadian parent?

5. Have you applied to Citizenship and Immigration Canada to retain your Canadian citizenship?

� No � YesReference number (if known)

1

2

3 Declaration of Applicant (to be completed by all applicants required to provide additional information on their Canadian citizenship)

If you answered Yes to question 1 OR 2,

If you answered No to questions 1 AND 2,

complete and sign the declaration below and attach the present form to your passport application.

you may be subject to loss of Canadian citizenship pursuant to section 8 of the Citizenship Act. If so,you will automatically lose your Canadian citizenship on your 28th birthday unless you take steps toretain it. If it is confirmed that you are subject to section 8 of the Citizenship Act and your 28th birthdayhas already passed, no passport will be issued to you. If it is confirmed that you are subject tosection 8 of the Citizenship Act and your 28th birthday is within five years, the validity of any passportissued to you will be limited to the day before your 28th birthday. For more information on retentionof Canadian citizenship, contact Citizenship and Immigration Canada at 1-888-242-2100 or visit theirwebsite at www.cic.gc.ca. Proceed to question 5 and complete and sign the declaration below andattach the present form to your passport application.

Welcome to the Adult and Child Canadian Passport ......Mailed-in applications are processed in...

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