Imm 5292 Form PDF Details

Navigating through the complexities of immigration documentation in Canada, one encounters various forms, each serving a distinct purpose. Among these, the IMM 5292 form stands out as a critical document for those seeking to amend their Record of Landing (IMM 1000), Confirmation of Permanent Residence, or Valid Temporary Resident Documents. This form spans three pages and is intentionally designed to correct personal details that might have been recorded inaccurately in official documents. Details such as one’s name, date of birth, place of birth, citizenship, sex, and marital status are among the key elements that can be corrected through this process. It also inquires about the applicant's history of convictions since their admission to Canada as a measure to maintain security and compliance with national laws. The IMM 5292 plays a pivotal role not only in ensuring the accurateness of an immigrant's legal records but also in impacting their eligibility for various benefits and services facilitated by the government. Citizenship and Immigration Canada, through this form, emphasizes the significance of truthfulness and the legal ramifications of fraudulent declarations. The process involves submitting not just the form but also accompanying documents that substantiate the requested amendments, underlining the need for a meticulously compiled application to avoid delays or rejections.

QuestionAnswer
Form NameImm 5292 Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesimm 5292 form, imm 5292 sample, canada immigration forms, canada pr form pdf

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Citizenship and

Citoyenneté et

PROTECTED WHEN COMPLETED - B

Immigration Canada

Immigration Canada

PAGE 1 OF 3

 

 

REQUEST TO AMEND THE RECORD OF LANDING (IMM 1000), CONFIRMATION OF PERMANENT RESIDENCE (IMM 5292 or IMM 5688) OR VALID TEMPORARY RESIDENT DOCUMENTS

PART A - PERSONAL DETAILS CONTAINED ON YOUR IMM 1000, IMM 5292 OR IMM 5688, OR VALID TEMPORARY RESIDENT DOCUMENTS

1

Client ID number/UCI

2

Surname(s) (Family name) (As it currently appears on your document)

3

Given name(s) (As it currently appears on your document)

4

Other name(s) used

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Other given name(s) used

 

 

 

 

 

 

 

 

 

 

 

6

 

Sex

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Male

 

 

Female

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

Date of birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

Place of birth (City, state/province and country)

 

 

9

 

Citizenship

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YYYY-MM-DD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

Passport number

 

 

 

 

 

Indicate if:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

On entry

 

 

 

 

Current

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

Date of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

 

Expiry

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

issue

 

 

 

 

 

 

 

YYYY-MM-DD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

date

 

 

 

 

 

 

 

 

 

 

YYYY-MM-DD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

Marital status

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Never married

 

 

 

 

 

 

Married

If you are married, is your spouse a

 

 

Yes

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Canadian citizen or permanent resident?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Widowed

 

 

 

 

 

 

Separated

 

 

 

 

Divorced

 

 

 

Common-law partner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14

Language of correspondence

 

 

 

 

 

English

 

 

 

 

 

 

French

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

Current mailing address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P.O. box

 

 

 

 

Apt./Unit

 

 

 

 

 

 

 

 

 

 

 

Street no.

 

 

 

 

 

 

 

 

Street name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/Town

 

 

 

 

 

Country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Province/State

 

 

 

 

 

Postal code

 

District

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16

Residential address Same as mailing address?

 

 

 

No

 

 

Yes

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Apt./Unit

 

 

 

 

Street no.

 

 

 

 

 

 

 

 

Street name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/Town

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Province/State

 

 

Postal code

 

District

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17

Telephone no.

 

 

Canada/US

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18

 

Alternate Telephone no.

 

 

Canada/US

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type

 

 

Country Code

 

 

No.

 

 

 

 

 

 

 

 

 

 

 

Ext.

 

 

 

 

Type

 

 

Country Code

 

No.

 

 

 

 

 

 

 

 

Ext.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

E-mail address: (Indicating an e-mail address will authorize all correspondence, including file and personal information, to be sent to the e-mail address you specify.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21

 

Date permanent residence or

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of original entry

 

 

 

 

 

 

YYYY-MM-DD

 

 

 

 

 

 

 

 

 

 

temporary residence was granted

 

 

 

 

 

 

 

YYYY-MM-DD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART B - INFORMATION TO BE AMENDED

1

Please indicate for which of the following you need a correction. If you have more than one valid temporary resident document, indicate the document ID number or if unknown, the document issue date and expiry date of the requested document.

Immigrant Visa and Record of Landing - Confirmation of Permanent Residence

Authorization to Return to Canada

 

Work Permit

ID No.:

 

Study Permit

ID No.:

 

Visitor Record ID No.:

 

Exclusion Order

 

 

Departure Order

 

Permit to Come Into or Remain in Canada -

 

 

Protected Person

 

 

 

 

 

 

 

Temporary Resident Permit

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OR

Issue date:

and

 

Expiry date:

 

 

(YYYY-MM-DD)

 

(YYYY-MM-DD)

 

 

 

 

 

 

 

 

 

 

 

OR

Issue date:

and

 

Expiry date:

 

 

(YYYY-MM-DD)

 

(YYYY-MM-DD)

 

 

 

 

 

 

 

 

 

OR

Issue date:

and

 

Expiry date:

 

 

(YYYY-MM-DD)

 

(YYYY-MM-DD)

 

 

 

 

 

 

 

 

 

 

 

This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants.

IMM 1436 (12-2012) E

(AUSSI DISPONIBLE EN FRANÇAIS - IMM 1436 F)

PAGE 2 OF 3

PART B - INFORMATION TO BE AMENDED (continued)

2

Surname(s) (Family name)

3

Given name(s)

 

 

 

 

4

Date of birth

YYYY-MM-DD

5

Place of birth (City, state/province)

6

Country of birth

7

Citizenship

8

Sex

 

 

9

 

Marital status

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Male

 

Female

 

 

 

Never married

 

Married

 

Common-law partner

 

Widowed

 

Divorced

 

 

Separated

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

Date of original entry

 

 

 

 

 

 

 

 

11

Date permanent residence or

 

 

 

 

 

 

 

 

 

 

 

 

 

YYYY-MM-DD

 

 

 

temporary residence was granted

 

 

YYYY-MM-DD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART C

1

If you are applying for an amendment to your IMM 1000, IMM 5292 or IMM 5688 and you are not a Canadian citizen, have you, since your admission to Canada as a permanent resident, been convicted of a crime or offence in Canada or elsewhere?

 

No

 

Yes

If yes, attach copies of the relevant court documents.

2

Reasons for requesting the amendment(s). (Attach another sheet if you need more space.)

STATEMENT

I certify that the statements made on this application document are true and correct. I understand that the approval of my request to amend my date of birth may affect my eligibility for benefit and services from other government institutions as that term is defined in the Privacy Act and may also result in the recovery from me by other government institutions of payments or benefits made to me under income support programs for which I was not eligible at the time the payments or benefits were paid.

Signature

 

Date

 

 

YYYY-MM-DD

The information you provide on this form is collected under the authority of the Immigration and Refugee Protection Act for the purposes of verifying your status in Canada. It will be stored in Personal Information Banks (PPU 053 entitled Permanent Resident Data System) CIC. Information may be systematically validated by other Canadian government institutions under the terms of an agreement or arrangement for the purposes of validating status and identity to administer their programs. In accordance with the Privacy Act and the Access to Information Act, individuals have a right to access, correction and protection of their personal information. Details on these matters are available at the CIC website (http://www.cic.gc.ca/english/department/atip/infosource/index.asp) and through the Citizenship and Immigration Canada Call Centre.

IMM 1436 (12-2012) E

PAGE 3 OF 3

DOCUMENT CHECKLIST

REQUEST TO AMEND THE RECORD OF LANDING, CONFIRMATION OF PERMANENT RESIDENCE OR VALID TEMPORARY RESIDENT DOCUMENTS

Ensure the following documents are included with your application. Check R each box once you enclose the item. Failure to provide a fully completed application or the necessary documents will result in the return of your application. Please make sure you complete this document and include it in your application as the cover page. Submit photocopies of documents unless we ask for originals as they will not be returned to you.

I HAVE ENCLOSED THE FOLLOWING ITEMS:

(See "Gather documents" section in the Instruction Guide for examples)

Original application form Request to Amend the Record of Landing, Confirmation of Permanent Residence or Valid Temporary Resident Documents (IMM 1436) completed and signed.

Photocopy of federal or provincial/territorial government issued photo identification OR if unavailable, photocopy of government issued or internationally recognized photo identification from outside Canada prior to your entry to Canada. (See "Gather Documents" section in the Instruction Guide for examples)

Photocopy of another form of government issued or internationally recognized identification from outside Canada before your entry to Canada indicating an error was made. (See "Gather Documents" section in the Instruction Guide for examples)

Copies of court documents if you have been convicted of a crime since becoming a permanent resident (if you are not a Canadian citizen).

Original Use of a Representative (IMM 5476) form completed and signed, if applicable.

Proof of urgency, if applicable.

IMMIGRATION DOCUMENT CONTAINING ERROR

Original Work Permit, Study Permit, Visitor Record or Permit to Enter and Remain in Canada (IMM 1442, IMM 1208, IMM 1102, IMM 1097 or IMM 1263).

Photocopy of the Record of Landing (IMM 1000) or Confirmation of Permanent Residence (IMM 5292 or IMM 5688).

Mail your completed application form and all required documents to:

Amendment to the Record of Landing or Confirmation of Permanent Residence or Valid Temporary Resident Documents Query Response Centre (QRC)

Citizenship and Immigration Canada Ottawa, Ontario

K1A 1L1

IMM 1436 (12-2012) E

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imm 5292 form pdf writing process detailed (part 1)

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The right way to fill out imm 5292 form pdf step 2

It's simple to get it wrong while completing your Country, so make sure you go through it again prior to deciding to send it in.

3. Completing Work Permit, ID No, Study Permit, ID No, Visitor Record, ID No, OR Issue date YYYYMMDD, OR Issue date YYYYMMDD, OR Issue date YYYYMMDD, and Expiry date YYYYMMDD, and Expiry date YYYYMMDD, and Expiry date YYYYMMDD, IMM E, AUSSI DISPONIBLE EN FRANÇAIS IMM, and This form is made available by is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Study Permit, ID No, and ID No inside imm 5292 form pdf

4. Now complete this next segment! In this case you've got all of these Surnames Family name, Given names, Date of birth, YYYYMMDD, Country of birth, Place of birth City stateprovince, Citizenship, Sex, Marital status, Male, Female, Never married, Married, Commonlaw partner, and Widowed form blanks to do.

Part number 4 of completing imm 5292 form pdf

5. To wrap up your form, this final subsection has several additional fields. Typing in I certify that the statements made, Signature, Date, YYYYMMDD, The information you provide on, and IMM E is going to conclude everything and you will be done in the blink of an eye!

IMM E, Date, and Signature inside imm 5292 form pdf

Step 3: When you have looked once again at the information in the fields, press "Done" to conclude your form at FormsPal. Right after setting up afree trial account here, you'll be able to download immigration form canada pdf or email it directly. The file will also be available in your personal account page with all of your changes. Here at FormsPal, we strive to guarantee that your details are stored protected.

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