Citizenship and Immigration Canada Citoyenneté et
人工智能的认识Immigration Canada PAGE 1 OF 1描写春夏秋冬的成语
IMM 5713 (12-2012) E PROTECTED WHEN COMPLETED - B
This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants. (AUSSI DISPONIBLE EN FRANÇAIS - IMM 5713 F)USE OF A FAMILY MEMBER REPRESENTATIVE FOR ONLINE APPLICATIONS
This form is for family members who wish to apply online together in one MyCIC submission. To do so, all members must complete this form (one per family) to appoint the family member who MyCIC account will be ud to submit the applications.
NOTE: If you appoint a family member as a reprentative, that person will be authorized to conduct business on your behalf and receive information on your ca file.1Full name
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Family name (Surname)
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Given name(s)Date of birth (YYYY-MM-DD)23Information on the family members Write name, date of birth and define the relationship (e.g. spou, son, daughter, etc.) of each family member to the reprentative.
Name Relationship to
family member reprentative Date of birth (YYYY-MM-DD)Family member 1
2
3
4
5SECTION A - FAMILY MEMBER REPRESENTATIVE Write the full name and date of birth of the family member to be appointed as reprentative
SECTION B - GRANTING PERMISSION TO THE FAMILY MEMBER REPRESENTATIVE Each fami
ly member 18 years of age and older listed in Section A must sign and date this ction to appoint the family member chon to reprent them
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Signature Date (YYYY-MM-DD)
5
4
3
2
1
Family
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IMPORTANT: Once permission is given to your spou or common-law partner or parent, the only way to revoke approval is to cancel the application and resubmit. The
application fees will not be refunded and fees will have to be paid again for another application.
Note: This permission applies to dependent children 18 years of age and older. Tho under the age of 18 do not have to provide approval.By signing Section B, I hereby give permission to the family member reprentative listed in Section A to submit the application, conduct business and receive information on my behalf. I declare that the information on this form and on the application that I have authorized my family member to submit on my behalf is truthful, complete and correct.
I declare that the information I have given is truthful, complete and correct.
Signature Date (YYYY-MM-DD)樱花女神
Warning! It is a rious offence to give fal or misleading information on this form.
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SECTION C - DECLARATION OF FAMILY MEMBER REPRESENTATIVE
The information you provide on this form is collected under the authority of the Immigration and Refugee Protection Act and will be ud in asssing your application according to the requirements of the Act. It will be retained in a Personal Information Bank identified in Infosource . The information may be shared with other organizations such as the Canada Border Services Agency (CBSA), the Royal Canadian Mounted Police (RCMP), the Canadian Security and Intelligence Service (CSIS), where there is an agreement or arrangement with a foreign government, in accordance with subction 8(2) of the Privacy Act . Pursuant to the Immigration and Refugee Protection Regulations , the information may also be shared with a regulatory body that is responsible for governing or investigating the conduct of reprentatives, such as a provincial and territorial law society, the Chambre des Notaires du Québec and the Immigration Consultants of Canada Regulatory Council (ICCRC). Under the Privacy Act and the Access to Information Act individuals have the right to protection of and access to their personal information. Details on the matters are available a and through the Citizenship and Immigration Call Centre. Infosource is also available in Canadian public libraries.
