Authorization Return Form Canada PDF Details

The authorization return form is a document used to authorize the release of personal information by Canadian organizations. It is also used to notify individuals when their personal information has been released. The form must be completed and signed by the individual, authorizing the disclosure of their personal information.Completed forms can be sent to the individual or organization that released the information, or to the Office of the Privacy Commissioner of Canada. If you have received an authorization return form from a Canadian organization, it is important that you fill out and sign it as soon as possible. This will allow them to release your personal information according to your wishes. If you have any questions about completing the form, or about what happens after it is filled out, please contact the organization that released

Question	Answer
Form Name	Authorization Return Form Canada
Form Length	6 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 30 sec
Other names	authorization to return to canada arc, authorization letter to return to canada, how to find authorization to canada forms on line, authorization to return to canada application

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Please complete this form if you are inadmissible to Canada because you were the subject of a removal order or have been

told by Canadian immigration you require an ARC to re-enter Canada.

Print Form

Immigroup -1180 Danforth Ave. Toronto, ON. M4J 1M3 P: 1-866-760-2623 F: 416-640-2623 E: info@immigroup.com

AUTHORIZATION TO RETURN TO CANDA

SERVICE ORDER FORM

INSTRUCTIONS

DOCUMENT CHECKLIST

1) Please complete the authorization to return to Canada form and the use of a

AUTHORIZATION TO RETURN TO CANADA

representative (IMM 5476) form

FORM & USE OF A REPRESENTATIVE FORM

2) Make copies of the ID pages of your passport and the proof of your departure

TWO PASSPORT PHOTOS

from Canada (Certificate of Departure, Removal Order)

COPIES OF THE ID PAGES OF YOUR PASSPORT,

3) Include the originals of your criminal clearance (pardon, police certificate,

AND PROOF OF DEPARTURE FROM CANADA

certificate of no record) for every country where you have lived for more than 6

(Certificate of Departure, Removal Order)

months, plus two passport-sized photos. If you were convicted of a crime in

Canada before the removal order, you must have a pardon to apply for an ARC.

EVIDENCE OF CRIMINAL CLEARANCE

For American citizens only: provide state certificates for every state you have

(PARDON, POLICE CERTIFICATES)

PROOF OF FUNDS AND LETTER OF

lived in for more than 6 months, and an FBI certificate.

4) Include proof of funds and a letter explaining why you should be allowed

EXPLANATION

re-entry. We can draft this letter at additional cost.

THIS ORDER FORM & ATTACHED CHECKLIST

5) Complete this order form in full, ensuring you all necessary documentation

as indicated by the checklist to the right.

APPLICATIONS MISSING THIS ORDER FORM

6) Please mail or drop off your application to our head office located at:

WILL NOT BE PROCESSED

1180 Danforth Ave, Toronto, ON M4J 1M3

Applications sent via regular mail will be preoessed less quickly.

SERVICE FEES & OPTIONS

REVIEW & SUBMISSION

REVIEW ONLY

PROCESSING TIME

-Includes submission of ARC and

-Includes reviewing application

1-12 weeks. Wait times vary from office to office and are wholly

drafting of your letter of

only. You must apply in person.

determined by the Canadian government.

explanation

$750+HST (CAD)

$500+HST (CAD)

AFTER SUBMITTING YOUR APPLICATION

Once we receive your application by email, fax, mail or in

person you will be contacted by a member of our team to

COMPLETE SERVICE*

determine any further steps you need to take.

-Includes obtaining pardon,

If you are unsure as to what documentation is required to

drafting your letter and

waive your inadmissibility, our agents will discuss this

submitting ARC.

GOVERNMENT FEE: $400

with you when we contact you.

$1000+HST (CAD)

*Complete service only available for

DISCLAIMER

those convicted in Canada

By signing below the applicant agrees to the following items:

CREDIT CARD INFORMATION

-I have read and accept the terms and conditions as listed at the following link

By signing below I agree that I will be charged the appropriate fee for the initial

http://www.immigroup.com/Disclaimer.php

-Immigroup is not responsible for applications lost in the mail or for failures in

application. I agree that this fee will be deducted upon receipt of order from the

fax or email

credit card I have provided.

Cardholder Name

-Immigroup is not responsible for applications that are denied. All fees are non-

refundable once applications are submitted to the government. Cancellation

Card Number

fees will apply if you withdraw your application before submission to the

government. No refunds will be given to clients who neglect to submit the

proper documentation in a timely manner.

Expiration Date

Security Code *

-I assert that I understand I am using Immigroup to apply for my ARC.

SIGN HERE:

*For Visa & MasterCard, the last 3 digits on the back of your card.

*For Amex, the last 4 digits on the front of your card.

Cardholder Signature:

THE APPLICANT MUST SIGN ABOVE

Your Email:

Immigroup -1180 Danforth Ave. Toronto, ON. M4J 1M3 P: 1-866-760-2623 F: 416-640-2623 E: info@immigroup.com

Application for an Authorization to Return to Canada

Demande de permis de retour au Canada

Section 1

Client ID- Numéro Client

File# - Référence #

Family Name- nom de famille

First Name - Prénom

Second Name(s)- Autre prénom

Other Name(s)- Autres noms

Date of Birth- Date de naissance

Lieu de Naissance

Citizenship- Citoyenneté

Place of Birth:

DD / MM / YYYY

Passport #- # de passeport

Expiry date-Date d’e piration

Country of issue- Pays de délivrance

Sex:

Marital status - É tat matrimonial

Male/Homme

Female/ Femme

Present occupation – Profession actuelle

Name and address of employer- Nom et adresse de

l’e

plo eur

Current mailing address- Adresse actuelle

Permanent address- Adresse Permanente

Telephone number - # de Téléphone

Email - Courriel

Immigration status in your actual country of residence - Statut

d’ i igratio da

s votre pays de résidence actuelle

Citizen

Permanent Resident

Visitor

Worker

Student

Citoyen(ne)

Résident Permanent

Visiteur

Traveilleur

Étudiant(e)

Valid until:

DD / MM / YYYY

I received – j’ai recu:

Exclusion order - Measure d’e clusio

Deportation Order- Measure d’e pulsio

SPOUSE OR COMMON-LAW AND CHILDREN

Section 2

EPOUX OU CONJOINT DE FAIT ET ENFANTS

Family name

Nom de Famille

First name

Prenom

Relationship

Lien de oarente

Date of birth

D-J/M/Y-A

Date de naissance

PlaceofBrith

Lieu de naissance

Citizenship

Citoyennete

Passport number

N° de passeport

Expiry date

D-J/M/Y-A

Date d'exDiration

Country of residence

Pays de residence

Section 3

During the past five years have you lived in any country other than your country of citizenship or permanent residence for more than six months? - Au cours des demiers cinq ans avez-vous vecu dans un pays pendant

plus de six mois, mis a part vos pays de naissance et de residence actuelle?	Yes/Qui

If "yes", list countries and length of stay	No/Non
	No/Non
5i la reponse a la question est «oui», indiquer Ie nom du pays et la duree du sejour

		Lenath of stav - Duree du seiour					Lenath of stav - Duree du seiour
Country - Pays		From		To	Country - Pays		From		To
	M	Y/A	M	Y/A		M	Y/A	M	Y/A

Section 4

Explain your purpose for travelling to Canada:

Full address in Canada and name of host (if applicable):

	Intended dates of travel: From: DD / MM / YYYY To: DD / MM / YYYY

	Section 5

	Have you ever – Répondre aux questions suivantes :

	Been treated for any serious physical or mental disorders or any communicable or chronic diseases?	Yes/ Oui
	Avez-vous deja ete traite(e) pour une maladie mentale ou physique grave, ou pour une maladie	Yes/ Oui
		No/ Non
	contagieuse ou chronique?	No/ Non
	contagieuse ou chronique?
	Committed any criminal offence in any country?	Yes/ Oui
	Committed any criminal offence in any country?	No/ Non
	Avez-vous deja ete trouve coupable d'un acte criminel ?	No/ Non
	Avez-vous deja ete trouve coupable d'un acte criminel ?
	Been refused admission to or ordered to leave Canada?	Yes/ Oui
	Vous a-t-on deja refuse I'entree au Canada ou oblige de quitter Ie Canada?	Yes/ Oui
		No/ Non
		No/ Non

	Been refused a visa to travel to Canada?	Yes/ Oui
	Vous a-t-on jamais refuse un visa pour Ie Canada?	Yes/ Oui
	Vous a-t-on jamais refuse un visa pour Ie Canada?	No/ Non
		No/ Non

	In periods of either peace or war, have you ever been involved in the commission of a war crime or	Yes/ Oui
	crime against humanity?	No/ Non
	En periode de paix ou de guerre, avez-vous deja participe a la commission d'un crime de guerre ou d'un	No/ Non

	crime contre I'humanite ?
	If you answered 'yes' to any of the above, please provide details below:	Yes/ Oui
	5i vous avez repondu "oui" a I'une ou plusieurs des questions, veuillez preciser ci-dessous.	No/ Non
		No/ Non

I declare that I have answered fully and truthfully all required questions in this application.

Je declare que les renseignements fournis dans ce formulaire sont complets, précis et conformes aux faits.

__________________	___________________
Signature of applicant	Date (dd/ mm/ yyyy)

Citizenship and	Citoyenneté et	PAGE 1 OF 2	IMM
Immigration Canada	Immigration Canada		IMM
Immigration Canada	Immigration Canada	PROTECTED WHEN COMPLETED - B 5476
		PROTECTED WHEN COMPLETED - B 5476

	USE OF A REPRESENTATIVE	(07-2011)
	USE OF A REPRESENTATIVE	E
		E

You do not need to hire an immigration representative, it is your choice. No one can guarantee the approval of your application. All the forms and information that you need to apply are available free at www.cic.gc.ca.

A representative is someone who has provided advice or guidance to you prior to submitting your application and/or someone who has your permission to conduct business on your behalf with Citizenship and Immigration Canada (CIC) and the Canada Border Services Agency (CBSA). You may have one representative only. If you appoint an additional representative, the previous representative will no longer be authorized to conduct business on your behalf and receive information on your case file.

I am:

appointing a representative. Complete Sections A, B and D.

cancelling the appointment of a representative. Complete Section A, C and D.

SECTION A: APPLICANT INFORMATION

1.Your full name

Family name (Surname)

Given name(s)

2.Your date of birth

3.If you have already submitted your application: Name of office where the application was submitted

Location of office

Type of application

(permanent residence, extension of study permit, etc.)

Day

Month

Year

4.Your Citizenship and Immigration Canada Identification number (if known)

Client Identification (ID) or

Unique Client Identifier (UCI) number

SECTION B: APPOINTMENT OF REPRESENTATIVE

•I authorize the following individual to serve as my representative and to conduct business on my behalf with Citizenship and Immigration Canada and Canada Border Services Agency.

•I authorize Citizenship and Immigration Canada and Canada Border Services Agency to release information from my case file and that of my dependent children under 18 years of age to my representative. This authorization is in accordance with the Privacy Act.

•I am aware that any information which would be subject to exemption, if I had the right of access under the Privacy Act or the Access to Information Act, will likely not be released.

5.Your representative's full name

Family name (Surname)

Given name(s)

6.Your representative: (choose one) is UNPAID and is a:

family member or friend

member of a non-governmental or religious organization

member of the Immigration Consultants of Canada Regulatory Council (ICCRC), a Canadian provincial or territorial law society, or the Chambre des notaires du Québec.

other

is or will be PAID and is a member in good standing of:

the Immigration Consultants of Canada Regulatory Council (ICCRC)

Membership ID number

a Canadian provincial or territorial law society

Which province or territory?

Membership ID number

the Chambre des notaires du Québec

Membership ID number

	This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants
IMM 5476 (07-2011) E	(DISPONIBLE EN FRANÇAIS - IMM 5476 F)

PAGE 2 OF 2

7.Your representative's contact information

Name of firm or organization (if applicable)

Mailing address

Postal code/ZIP

Telephone numberCountry code Area codeNumber

	(	)	(	)

Fax number	Country code			Area code	Number
	(	)	(	)

E-mail address (if applicable)

By indicating your representative's e-mail address, you are hereby authorizing Citizenship and Immigration Canada to transmit your file and personal information to this specific e-mail address.

8.Your representative's declaration:

•I declare that the information in Section B is truthful, complete and correct.

•I understand and accept that I am the person appointed by the applicant to conduct business on the applicant or sponsor's behalf with Citizenship and Immigration Canada and Canada Border Services Agency.

Signature of representative

Date

Day

Month

Year

SECTION C: CANCEL THE APPOINTMENT OF A REPRESENTATIVE

I withdraw my authorization for this person to serve as my representative, to receive information on my case file and to conduct business on my behalf with Citizenship and Immigration Canada and Canada Border Services Agency.

9.Your representative's full name

Family name (Surname)

Given name(s)

Name of firm or organization (if applicable)

SECTION D: YOUR DECLARATION

10.

•I declare that the information I have given is truthful, complete and correct.

•I understand all the foregoing statements, having asked for and obtained an explanation for every point that was not clear to me.

Signature of applicant

Date	Day Month	Year
Date

Signature of spouse or common-law partner (if applicable)

Date

Day

Month

Year

Warning! It is a serious offence to give false or misleading information on this form.

The information you provide on this form is collected under the authority of the Immigration and Refugee Protection Act and will be used in assessing your application according to the requirements of the Act. It will be retained in a Personal Information Bank identified in Infosource. It may be shared with other organizations in accordance with the consistent use of information under the Privacy Act. 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 these matters are available at infosource.gc.ca and through the Citizenship and Immigration Call Centre. Infosource is also available in Canadian public libraries.

IMM 5476 (07-2011) E

A copy of this checklist.

฀

employment;

฀ Two passport-sized photographs;

฀ A copy of your current passport bio-data page (i.e. the page with the name, photo, place of birth, date of issue, etc.); and

Detailed explanation of why you want to return to Canada;

Proof of funds (bank statements, pay slips) and employment letter indicating the type and duration of

฀

If you incurred a criminal conviction in Canada, you must apply for a National Pardon in Canada and submit it with your application. You can apply for a pardon by writing to the National Parole Board in Canada at Clemency and Investigations Division, National Parole Board, 410 Laurier Ave. West, Ottawa, ON, K1A OR1, Canada. This application cannot be made at any mission abroad. The following link explains how to obtain this: http://www.npb-cnlc.gc.ca/;

฀

฀ Proof that you appeared before an immigration officer at a port of entry to verify your departure from Canada i.e. a Copy of the Certificate of Departure (IMM0056B) and/or a Removal Order;

Recently issued Police Certificate from all the countries where you have resided months since the age of 17 years. For more information go to: http://www.cic.gc.ca/english/information/security/police-cert/index.asp

for more than 6

Use of a Representative

(IMM 5476), if applicable;

฀

Application for Authorization to Return to Canada;

Processing fees in the amount of $400 Canadian by bank draft made payable to the Receiver General for Canada. We do not accept personal cheques. Do not send cash through the post. (Please note that applications received without fees will be returned);

฀

ARC CHECK LIST

You must answer every question. If not applicable, write N/A.

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Find out how to complete authorization to return to canada sample letter stage 1

2. The next stage is to fill out these particular fields: Section Family Name nom de famille, Client ID Numéro Client File , First Name Prénom, Second Names Autre prénom, Other Names Autres noms, Date of Birth Date de naissance, Citizenship Citoyenneté, Sex MaleHomme Present occupation , Female Femme, Marital status É tat matrimonial, Name and address of employer Nom, Current mailing address Adresse, Permanent address Adresse, Telephone number de Téléphone, and Email Courriel.

How to fill in authorization to return to canada sample letter stage 2

3. This next portion will be focused on Telephone number de Téléphone, Email Courriel, Immigration status in your actual, Citizen, Permanent Resident, Visitor, Citoyenne Résident Permanent, Worker Traveilleur Étudiante, Student, Exclusion order Measure, Deportation Order Measure, Section , Family name Nom de Famille First, SPOUSE OR COMMONLAW AND CHILDREN, and EPOUX OU CONJOINT DE FAIT ET - complete all of these empty form fields.

Email Courriel, Permanent Resident, and Exclusion order Measure inside authorization to return to canada sample letter

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How you can complete authorization to return to canada sample letter step 4

5. Because you approach the last parts of this form, you'll find several extra things to do. Mainly, During the past five years have, plus de six mois mis a part vos, If yes list countries and length, i la reponse a la question est oui, YesQui, NoNon, Lenath of stav Duree du seiour, Country Pays, Lenath of stav Duree du seiour, Country Pays, Section Explain your purpose for, and Full address in Canada and name of must all be filled out.

Completing part 5 in authorization to return to canada sample letter

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Authorization Return Form Canada PDF Details

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