Child General Passport Form PDF Details

The Child General Passport Application form is a crucial document for Canadian children under 16 years old, enabling them to travel internationally. Carefully updated to reflect current requirements, it is accessible in both English and French, emphasizing the importance of facilitating travel for young Canadians. To ensure a smooth application process, applicants are urged not to make travel arrangements until they have received the passport. Highlighting the importance of this document, it is emphasized that a Canadian passport is a universally accepted identification document when traveling abroad. Application details include who is eligible to apply on behalf of a child, stressing the need for one of the parents, custodial parent, or legal guardian to do so. The validity period of a passport is tailored to the child's age, extending a maximum of 5 years for those aged 3 to 15, and up to 3 years for those under 3. A thoughtful inclusion is the provision for a one-time replacement passport for infants within the first year, recognizing the rapid changes in young children's appearances. A comprehensive checklist outlines the application's necessities, ranging from completed forms to photos that accurately represent the child, and the stipulated fee emphasizes affordability while detailing payment methods. Application venues are conveniently located across Canada and the USA, providing straightforward access for applicants. Additionally, the form includes essential sections on the child's personal information, parental consent, and previous Canadian travel documents, streamlining the application process while safeguarding the child's identity and citizenship verification. The requirement for a guarantor adds an extra layer of verification, ensuring the application's integrity. Rules for passport photos are clearly defined, catering specifically to children's unique requirements and ensuring consistency. Lastly, the form touches on the protection of personal information, reassuring applicants of the confidentiality and security of their data, showcasing a comprehensive approach to passport application for children.

QuestionAnswer
Form NameChild General Passport Form
Form Length8 pages
Fillable?No
Fillable fields0
Avg. time to fill out2 min
Other nameschild canadian passport application fillable pdf, instructions for completing simplified canadian passport, child canadian passport renewal form, fillable child passport application canada

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CHILD GENERAL PASSPORT APPLICATION

for Canadians under 16 years of age applying in Canada or from the USA INSTRUCTIONS

Aussi disponible en français

Forms are regularly updated. Applicants are encouraged to use the interactive form available online at passportcanada.gc.ca.

 

A

Entitlement to a Canadian Passport

 

Important Notice—We recommend that you not make any travel plans until you receive the requested 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.

Canadians 16 years of age or over must use form PPTC 153, Adult General Passport Application.

BWho May Apply for a Passport on Behalf of a Child?

One of the parents

The custodial parent in cases of separation or divorce

The legal guardian

 

C

Period of Validity for Passports Issued to Children

 

For 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 photos are a current and true likeness of the child, they must be taken within one month of the date the application is submitted.

D

Requirements Checklist

Both pages of the application form completed and signed within the last 12 months.

Two (2) identical unaltered passport photos of the child.

Application form and one of the photos certified by your guarantor.

Proof of Canadian citizenship (original only).

Any valid Canadian travel document (passport, certificate of identity or refugee travel document) issued to the child.

Acceptable proof of parentage.

All documents that refer to custody of, mobility of, or access to the child, including the divorce judgment (if applicable).

The fee.

Note: All documents submitted throughout the passport application process that are in a language other than English or French must be translated by a certified translator.

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

E

Fee

Note: Passport Canada does not accept personal cheques or payment in cash for applications submitted in Canada.

For a child aged – 3 to 15 years—C$37

Important

– under 3 years—C$22

Every person who requests a passport service must pay the

 

Accepted methods of payment (Canadian funds only)

applicable fee.

Debit card (in person only).

Applicants who cancel their application or are refused a passport

Credit card (fill out and detach section F of this form and enclose

are not eligible for a refund of the passport service fee.

it with your application).

Administrative fees and applicable interest will be applied to all

Certified cheque or money order/international money order

dishonoured payments.

(postal or bank) payable to the Receiver General for Canada.

Fees are subject to change.

 

 

 

F

 

 

 

 

Credit Card Information

 

 

 

 

 

 

COMPLETE and submit with your application if you are paying by credit card.

 

 

 

 

 

 

Card type:

Visa

MasterCard

American Express

 

 

 

 

 

 

Name as it appears on card

 

 

Card number

 

 

Date of expiry

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Month

 

Year

Name of child

 

 

 

 

 

FOR OFFICIAL USE ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AUTHORIZATION—I authorize Passport Canada to

Signature of cardholder

Date

 

 

 

 

charge

 

 

 

to my credit card.

 

 

 

 

Year

 

Month

 

Day

C$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PPTC 155 (2012-10) R6 Page 1 of 8

G

Applying in Person

Canadians can submit an application in Canada at:

a Passport Canada regional office

a participating Canada Post office

a participating Service Canada Centre

All service locations are available online at passportcanada.gc.ca.

For Canadians submitting an application from the USA:

If the child requires a passport in exceptional circumstances, contact the nearest Government of Canada office. A list of Government of Canada offices in the USA is available online at travel.gc.ca.

H

Applying by Mail

Mailed-in applications are processed in Canada.

BY MAIL

BY COURIER

Passport Canada

Passport Canada

Foreign Affairs and

22 de Varennes Street

International Trade Canada

Gatineau QC J8T 8R1

Gatineau QC K1A 0G3

CANADA

CANADA

 

The original documents that you enclose with your application are valuable. We recommend that you use a courier or mail service that allows you to trace your mail.

I

Contact Information

General information is available 24 hours a day, 7 days a week. Specific information is available Monday to Friday from 7:30 a.m. to 8 p.m. ET.

INFORMATION ON PASSPORTS, FEES AND PROCESSING TIMES

Website:

passportcanada.gc.ca

Toll-free:

1-800-567-6868

Outside continental USA:

819-997-8338

TTY (for persons who are Deaf or hard of hearing)

 

Toll-free:

1-866-255-7655

INFORMATION ON TRAVEL REPORTS, WARNINGS AND REQUIREMENTS

Website:

travel.gc.ca

Application forms are available in large print.

A passport application instruction booklet is available in Braille.

PPTC 155 (2012-10) R6

Page 2 of 8

J

Child's Personal Information

SURNAME AND GIVEN NAME(S) TO APPEAR IN PASSPORT

Write the child's name as you want it to appear in the passport. If you are requesting a passport in a name that is different from the name that appears on the child's documentary evidence of citizenship, one (1) of the following documents will be required to confirm the child's change of name:

Legal change of name order,

Adoption order,

Birth certificate or citizenship certificate issued in the new name.

SURNAME (LAST NAME) AT BIRTH/FORMER SURNAME (FORMER LAST NAME)

Complete 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 BIRTH

The child's place of birth must be provided on the application form. If you do not wish the child's place of birth to appear in the passport, submit form PPTC 077, Request for a Canadian Passport Without a Place of Birth, available online at passportcanada.gc.ca.

SIGNATURE

Children 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.

Note: At no time should a person other than the child sign in the signature box, section 1.

K

Information on Applicant

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. Where a legal guardian is the applicant, the other legal guardian(s), as the case may be, is (are) also requested to participate. Proof of legal guardianship is required.

PARENTAGE LINK BETWEEN THE CHILD AND THE PARENT(S)

You must provide one of the following acceptable proofs of parentage documents demonstrating the relationship between the child and the parent(s):

a detailed birth certificate from Canada or a foreign country where the child was born, indicating the name of the parent(s); or an order of adoption indicating the name of the adopting parent(s).

Exception: An application submitted on behalf of a child will be accepted without proof of parentage only if:

a Canadian travel document was previously issued to the child in his or her name; and

the parent(s)/legal guardian(s) who participated in the previous application is (are) the same one(s) who is (are) participating in this application.

CUSTODY, SEPARATION AND DIVORCE

Where 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 of, mobility of, or access to the child must be provided. If a divorce has been granted, a copy of the divorce judgment or order must also be provided. Where joint custody provisions exist, either parent may apply.

RELATIONSHIP WITH OTHER PARENT

Indicate your current relationship with the other parent: single (no relationship), common law, married, separated, divorced, widowed. Indicate date of marriage to the other parent, if applicable. Additional information or documentation may be required.

CHILDREN IN FOSTER CARE OR UNDERGOING AN ADOPTION PROCESS IN CANADA

In addition to this form, you must complete either form PPTC 463A, PPTC 463B or PPTC 463C, Additional Information for Children in Foster Care and Children Undergoing an Adoption Process in Canada, available online at passportcanada.gc.ca. From the home page, click on Apply or renew then click on Children in foster care or in the process of adoption.

Where a legal guardian is the applicant, proof of legal guardianship must be provided.

 

L

Previous Canadian Travel Document

 

Enclose any valid Canadian travel document (passport, certificate of identity or refugee travel document) issued to the child. If the child's current passport is valid for more than 12 months from the date the application is submitted, provide a written explanation as to 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 travel document.

Note: If a valid Canadian travel document has been lost, stolen, damaged or is inaccessible, complete form PPTC 203, Declaration, available online at passportcanada.gc.ca. A Canadian travel document, once reported lost or stolen, is no longer valid. If found, it is not to be used for travel and must be returned immediately to Passport Canada or if abroad to the nearest Government of Canada office.

PPTC 155 (2012-10) R6

Page 3 of 8

 

M

Proof of Canadian Citizenship

 

Provide one (1) of the documents indicated in section 4 of the application form (original only). It will be returned to you. Additional information may be required to confirm the child's citizenship.

CERTIFICATE OF BIRTH IN CANADA

Only official birth documents issued by the vital statistics authority of the child's province or territory of birth in Canada are accepted. This includes detailed birth certificates indicating the name of the parent(s). Certain exceptions may apply. More information is available online at passportcanada.gc.ca.

CERTIFICATE OF CANADIAN CITIZENSHIP

Commemorative documents of citizenship are not accepted. If the child requires a certificate of Canadian citizenship, contact:

CITIZENSHIP AND IMMIGRATION CANADA

Website (in Canada and in the USA):

cic.gc.ca

Toll-free in Canada:

1-888-242-2100

TTY in Canada (for persons who are Deaf or hard of hearing):

1-888-576-8502 (from 8 a.m. to 4 p.m. ET)

 

 

N

Declaration of Guarantor

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

The guarantor must:

be a Canadian citizen 18 years of age or over;

hold a five-year Canadian passport that is valid or has been expired for less than one year on the day you submit your application;

have been 16 years of age or over when the application was submitted for the passport identified in section 6 of this application form; 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. A family member or person residing at the same address as you (the applicant) may be the guarantor provided that the individual meets the specified requirements.

provide the requested information contained in the passport issued in his or her name;

be accessible to Passport Canada for verification;

reside in Canada, in the USA or in any of the following countries or territories: Bermuda, American Samoa, Guam, the Marshall Islands, the Midway Islands, the Northern Mariana Islands, Puerto Rico, Saint-Pierre et Miquelon or the US Virgin Islands.

It is not necessary that the guarantor reside in the same country as the applicant.

The parent or legal guardian applying for a passport for the child, cannot sign as guarantor. However, if applicable, the other parent or legal guardian of the child may sign as guarantor.

The 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 both pages of the application 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 it.

Passport Canada reserves the right to request an alternate guarantor.

The applicant must not assist the guarantor in performing his or her duties.

If your guarantor requires assistance, contact Passport Canada.

If you have not known an eligible guarantor for at least two (2) years, complete form PPTC 132, Statutory Declaration in Lieu of Guarantor, available at any Passport Canada regional office in Canada or any Government of Canada 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.

PPTC 155 (2012-10) R6

Page 4 of 8

 

O

Rules for Canadian Passport Photos

 

You must submit two (2) identical photos with each passport application.

THE PHOTOS MUST

be taken by a commercial photographer;

be clear, sharp and in focus. Photos may be in colour or in black and white;

have a neutral facial expression (eyes open and clearly visible, mouth closed, no smiling);

have uniform lighting—no shadows, glare or flash reflections;

be taken straight on with the face and shoulders centered and squared to the camera;

be taken in front of a plain white or light-coloured background to clearly distinguish the person from the background. Photos must reflect/represent natural skin tones;

be originals that have not been altered in any way or taken from an existing photo;

reflect your current appearance (taken within the last 12 months); and

Frame Height 70 mm (2 3/4 in.)

Minimum Face Height

31 mm (1 1/4 in.)

Maximum Face Height

36 mm (1 7/16 in.)

Photo Co. Ltd.

111 Any Street

Any Town, COUNTRY

Photo taken

Date

Icer t if y t his t o be a t r ue likeness of

(child's name)

Guarantor's Signature

be professionally printed on plain, high quality photographic paper (photos printed at home and photos printed on heavy weight paper are not acceptable).

Frame Width 50 mm (2 in.)

Not actual size. Refer to measurements above.

THE FOLLOWING MUST APPEAR ON THE BACK OF ONE PHOTO

The name and address of the photo studio and the date the photo was taken. The photographer may use a stamp or handwrite this information (stick-on labels are not acceptable).

The guarantor's signature.

EXTRA DETAILS

Glasses, including tinted prescription glasses, may be worn in photos as long as the eyes are clearly visible and there is no glare in the glasses. Sunglasses and the red-eye effect are unacceptable.

Hats and head coverings must not be worn, unless worn for religious beliefs or medical reasons. However, the head covering must not cast shadows on the face and the full face must be clearly visible.

CHILD PHOTOS

The above rules apply equally to photos of children;

The photo must show the child's head and shoulders only. The hands of the parent or child must not appear in the photo.

Passport Canada recognizes that it is difficult to obtain a neutral expression from a newborn and will be tolerant in this respect.

If applying for a one-time replacement passport for a child, you must include a photo that was taken within one month of the date the application is submitted.

P

Protection of Information

All personal information provided on this application form is protected and used in accordance with the provisions of the Privacy Act (Personal Information Bank No. DFAIT PPU 030). Personal information is collected by Passport Canada 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 Operations Bureau of Foreign Affairs and International Trade Canada in the event that the child requires assistance while travelling abroad. The guarantor's information is also checked to determine whether the person meets the requirements to act as a guarantor. All information provided, including information regarding the parents, is subject to routine verifications and security queries including validation of Canadian citizenship with Citizenship and Immigration Canada.

To strengthen the security of the Canadian passport, Passport Canada uses facial recognition technology to convert the child's photo into a biometric template for comparison with the Passport Canada database of photos. The photo is then incorporated into the passport as a digital image. Biometric templates are retained for a maximum of 12 years.

Passport Canada uses the services of third parties to receive passport applications submitted in person. All parties ensure that all personal information is protected and used in accordance with the provisions of the Privacy Act.

Passport Canada may contact the applicant or passport holder to solicit feedback about passport services.

PPTC 155 (2012-10) R6

Page 5 of 8

IMPORTANT INFORMATION CONCERNING CHILDREN TRAVELLING ABROAD

For more information, visit international.gc.ca and travel.gc.ca/child.

 

Q

Travelling with Children or Children Travelling Alone

 

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

 

R

Documentation to Facilitate Travel Abroad

 

 

 

 

 

The following documents may be required to support the entry of a child to another country: Birth certificate showing the names of both parents.

Documents pertaining to custody.

If 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.

 

S

Documentation and Tips to Facilitate the Return to Canada

 

 

 

 

 

The following tips may help to avoid delays when a child is returning to Canada:

Make sure you carry proper identification for yourself and any children travelling with you to assist in confirming your legal right or authorization to enter Canada upon your return.

If you have custody of the child, carry copies of documents specifying custody rights to the child.

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 with a group, ensure you are in the same vehicle as the child you are accompanying when arriving at a border crossing.

Have the child memorize a telephone number to call in an emergency.

TCustody Information

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 the documentation that may be required relating to custody of the child.

For further information, contact:

 

Foreign Affairs and International Trade Canada:

 

In Canada

1-800-267-6788

Outside Canada

613-944-6788

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

You may order a copy online or access an online version:

 

Website

travel.gc.ca

For a free copy, call:

 

In Canada

1-800-267-8376

Outside Canada

613-944-4000

 

 

PPTC 155 (2012-10) R6

Page 6 of 8

 

 

 

CHILD GENERAL PASSPORT APPLICATION

INFORMATION

 

 

 

 

 

 

 

 

PROTECTED

 

 

 

 

 

for Canadians under 16 years of age applying in Canada or from the USA

1.4

 

 

 

 

 

 

 

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 to issue 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 refused.

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

1

 

Child's Personal Information (see Instructions, section J)

 

 

 

 

 

 

 

 

Surname (last name)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Given name(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of travel

Surname (last name) at birth/former surname (former last name)

 

 

 

 

Month

Day

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of birth

 

Place of birth

 

 

 

 

 

 

 

 

 

 

 

 

 

Year

 

Month

 

Day

City

 

Country

 

 

 

Prov./Terr./State (if applicable)

 

 

 

 

 

 

 

 

 

 

Sex

Female

 

Eye colour

Current hair colour

 

Height (cm/in)

 

 

Weight (kg/lbs)

 

 

Male

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current home address

 

 

 

 

 

 

 

 

 

 

 

 

Number

Street

 

 

Apartment

City

 

 

Province/Territory/State

Postal/ZIP code

Mailing address (if different from above)

 

 

 

 

 

 

 

 

 

 

 

 

Number

Street

 

 

Apartment

City

 

 

Province/Territory/State

Postal/ZIP code

Children 11 years of age or over must sign in the signature box. Note: At no time should a person other than the child sign in the signature box.

Date

 

 

Signed at

 

Year

Month

Day

City

Province/Territory/State

 

 

 

 

 

 

 

 

Void if signature touches border

Signature of child (see Instructions, section J)

 

2

Information on Applicant (see Instructions, section K)

 

Is the child currently the subject of an adoption process or partially or fully in the care of a provincial/territorial family services organization in Canada?

Are there any separation agreements, court orders or legal proceedings pertaining to custody of, mobility of, or access to the child?

No Yes

No Yes

If yes, include all documents

 

 

 

Applicant (parent or legal guardian)

 

 

 

 

 

Other parent or legal guardian

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Surname (last name) at your birth

 

 

 

 

 

 

 

 

 

Surname (last name) at your birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Given name(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

Given name(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of birth

 

 

 

 

Country of birth

 

 

 

 

 

 

Date of birth

 

 

Country of birth

 

 

 

 

 

 

 

Year

Month

 

Day

 

 

 

 

 

 

 

 

 

 

 

 

Year

 

Month

Day

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Relationship with other parent

 

Date of marriage (if applicable)

 

Relationship with parent applying

Date of marriage (if applicable)

 

 

 

 

 

 

 

 

 

 

 

Year

 

Month

 

Day

 

 

 

 

 

 

 

 

Year

 

Month

Day

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Daytime telephone number

 

 

Evening telephone number

 

Daytime telephone number

Evening telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cell number (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

Cell number (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DECLARATION—I solemnly declare that the child named above is a Canadian

 

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

 

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

 

statements made in this application are true. I declare that I have read and understood

 

the WARNING to all applicants and guarantors at the top of this page.

 

 

 

the WARNING to all applicants and guarantors at the top of this page.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of applicant (also sign section 5)

 

 

Date

 

 

Signed at

 

Signature of other parent or legal guardian

Date

 

 

Signed at

 

Aussi disponible en français

 

 

 

 

 

 

 

 

 

 

PPTC 155 (2012-10) R6

 

 

 

 

 

 

 

 

 

Page 7 of 8

Declaration of Applicant

3

Previous Canadian Travel Document (see Instructions, section L)

Has a Canadian travel document (passport, certificate of identity or refugee travel document) been issued to the child and is it still valid?

No

Yes (specify)

Number

Date of issue

Year Month Day

Place of issue

If yes, include it with your application.

Would you like the previous passport returned to you? If not, it will be securely destroyed by Passport Canada to protect the child's

personal information.

Yes, please return the passport to me.

Note: If a valid Canadian travel document has been lost, stolen, damaged or is inaccessible, complete form PPTC 203, Declaration, available online at passportcanada.gc.ca. A Canadian travel document, once reported lost or stolen, is no longer valid.

4

Proof of Canadian Citizenship (see Instructions, section M)

ATo be completed if the child was born in Canada. Provide one (1) of the documents listed below (original only):

Birth certificate in Canada

Registration number

Date of issue

 

 

 

 

 

Certificate of Canadian citizenship

Certificate number

Date of issue/Effective date of citizenship

 

 

 

 

 

BTo be completed if the child was born outside of Canada. Provide the following document (original only):

 

 

Certificate of Canadian citizenship

Certificate number

Date of issue/Effective date of citizenship

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Surname (last name) of applicant

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 7.

Signature of applicant

Date

Year

Month Day

Signed at

City

Province/Territory/State

 

6

 

 

 

 

Declaration of Guarantor (see Instructions, section N)

 

 

 

 

 

 

 

 

 

 

 

 

The guarantor must know the applicant identified in section 5.

 

 

 

 

 

 

 

 

 

 

Note: Section to be completed by the guarantor only if the applicant has completed and signed both pages of this application form.

 

 

 

 

Surname (last name)

 

 

Given name(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of birth

 

 

 

Canadian passport number

Date of issue

 

 

 

 

Date of expiry

 

 

 

 

 

 

 

 

 

Year

 

Month

Day

 

Year

Month

 

Day

Year

 

Month

 

Day

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Surname (last name) in passport, if different

Daytime telephone number

Evening telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current home address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number Street

 

 

 

Apartment City

 

 

 

 

 

 

Province/Territory/State Postal/ZIP code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full name of applicant

 

 

Full name of child

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I have known

DECLARATION—I solemnly declare that I have known the applicant identified above personally for at least two (2) years and have

 

 

 

 

the applicant

knowledge of the child. I have signed on the back of one (1) photo to certify that the image is a true likeness of the child. I declare that

 

 

 

 

parent or

I have read and understood the WARNING to all applicants and guarantors on page 7.

 

 

 

 

 

 

 

 

 

 

guardian for

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of guarantor

Date

 

 

Signed at

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Year

Month

Day

 

 

 

 

 

 

 

 

 

 

 

Number of years

 

 

 

 

 

 

 

 

City

 

Province/Territory/State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

Emergency Contact Information (optional)

We recommend that you provide the name of someone who would not normally travel with the child. This information is helpful if the child has an accident or becomes ill while travelling outside of Canada.

Surname (last name)

 

 

Given name(s)

 

 

Relationship to the child

 

Daytime telephone number

Evening telephone number

 

Cell number

 

 

Current home address

 

 

 

 

 

 

 

 

 

 

Number Street

 

Apartment City

 

Province/Territory/State Postal/ZIP code

 

 

 

 

 

 

 

PPTC 155 (2012-10) R6 Page 8 of 8