Form IMM 5475 at a glance
What it is: Authority to Release Personal Information to a Designated Individual: complete if you authorize Citizenship and Immigration Canada and Canada Border Services Agency to release information from your case file to someone other than yourself.
Who signs: Sign on the Signature of applicant line and enter the Date (YYYY-MM-DD).
Where and when to file: If you have already submitted your application: Send this form to the office where you submitted your original application.
Your dependent children who are 18 years of age or older must complete their own copy of this form if they wish to authorize CIC and CBSA to release their information to a designated individual.
A filled-in Form IMM 5475 example: authorizing a designated individual
How to fill out Form IMM 5475, box by box
Choose one
Choose one: I authorize Citizenship and Immigration Canada and Canada Border Services Agency to release information from my case file, or I withdraw my authorization to release information from my case file.
Your full name
In box 1, enter Your full name: Family name (Surname) and Given name(s).
Your date of birth (YYYY-MM-DD)
In box 2, enter Your date of birth (YYYY-MM-DD).
If you have already submitted your application
If you have already submitted your application, in box 3 enter the Name of office where the application was submitted, the Location of office and the Type of application (permanent residence, extension of study permit, etc.).
Your Client Identification (ID) or Unique Client Identifier (UCI) number
In box 4, enter your Client Identification (ID) or Unique Client Identifier (UCI) number, if known.
Your designated individual's full name
In box 5, enter Your designated individual's full name: Family name (Surname) and Given name(s).
Your designated individual's contact information
In box 6, enter Your designated individual's contact information: the Name of firm or organization (if applicable), then under Mailing address the Apt/Unit, Street no., Street name, City/Town, Province/State/Territory, Country or territory and Postal code/Zip, then the Country Code and Area Code and Telephone number.
E-mail address (if applicable)
Enter the E-mail address (if applicable).
Your declaration
In box 7, Your declaration, you state that you understand the following statements, having asked for and obtained an explanation for every point that was not clear to you.
If you are giving your authorization: you authorize Citizenship and Immigration Canada and Canada Border Services Agency to release information from your case file to the individual named in Your designated individual's full name. You understand that this consent only allows the disclosure of your personal information and that of your dependent children under 18 years of age. You are aware that some information may not be released if it is subject to exemption under the Privacy Act or the Access to Information Act. You further authorize the designated individual to update the address listed in your file, as required.
If you are withdrawing your authorization: you withdraw your authorization to release information from your case file to the individual named in Your designated individual's full name.
Sign on the Signature of applicant line and enter the Date (YYYY-MM-DD).
Signature of spouse common-law partner (if applicable)
If your spouse or common-law partner wishes to release personal information to the same designated individual, they should sign in the space provided.
If your spouse or common-law partner signs, they use the Signature of spouse common-law partner (if applicable) line and enter the Date (YYYY-MM-DD).
More rules for Form IMM 5475
Failure to complete the form in full will result in a delay to processing.
The Privacy Act gives individuals the right of access to, protection, and correction of their personal information. If you are not satisfied with the manner in which IRCC handles your personal information, you may exercise your right to file a complaint to the Office of the Privacy Commissioner of Canada.
Common questions about Form IMM 5475
What is the IMM 5475 form?
Complete this form if you authorize Citizenship and Immigration Canada (CIC) and Canada Border Services Agency (CBSA) to release information from your case file to someone other than yourself. The individual you designate will be able to obtain information such as the status of your application and will be able to change your address if you move.
Where do I file it?
If you have not yet submitted your application: Send this form along with your application to the office listed in your respective application kit. If you have already submitted your application: Send this form to the office where you submitted your original application.
When is this form not the right one?
The individual you designate will not be a representative who can conduct business with CIC and CBSA on your behalf. If you wish to be represented, you must complete and submit form Use of a Representative (IMM 5476).
Sources
[1] Form IMM 5475 (05-2021), Authority to Release Personal Information to a Designated Individual, Immigration, Refugees and Citizenship Canada (the Official source link on this page).