Pptc 040 Form – Fill Out and Use This PDF

ADULT ABROAD GENERAL PASSPORT APPLICATION

for Canadians 16 years of age or over applying outside of Canada and the USA

Warning: Any false or misleading statement with respect to this application and any supporting document, including the concealment of any material fact, may result in the refusal to issue a passport, the revocation of a currently valid passport, and/or the imposition of a period of refusal of passport services, and may be grounds for criminal prosecution as per subsection 57 (2) of the Criminal Code (R.C.S. 1985, C-46).

Type or print in CAPITAL LETTERS using black or dark blue ink.	Read Instructions

1 PERSONAL INFORMATION (SEE INSTRUCTIONS, SECTION H)		Anticipated date of travel
Surname (last name) requested to appear in the passport		It is recommended that you do not
		finalize travel plans until you receive
		the requested passport.
		Month Day
Given name(s) requested to appear in the passport
				Unknown

All former surnames (including surname at birth if different from above. These will not appear in the passport.)

Mother's surname at birth

Place of birth

City					Country		Prov./Terr./State (if applicable)
Date of birth		(YYYY-MM-DD)	Sex				Natural eye colour	Height (cm or in)
				F Female	M Male	X Another gender
Current home address
Number	Street			Apt.	City	Country		Postal/ZIP code

Mailing address (if different from current home address)

Number

Street

Apt.

City

Country

Postal/ZIP code

Note: You or your guarantor can complete this section, with the exception of the four fields which must be completed by your guarantor.

Surname (last name) in passport	Given name(s)

Current home address (see section J-A) or Business address (see section J-B)

Number

Street

Apt.

City

Country

Postal/ZIP code

PPTC 040 (02-2021)

(DISPONIBLE EN FRANÇAIS - PPTC 041)

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Read Instructions

• Has a Canadian travel document (passport, certificate of identity or refugee travel document) been issued to you in your current name or any other name?

No	Yes (specify)	Number		Date of issue (YYYY-MM-DD)

If the Canadian travel document is still valid, you must include it with your application.

Any passport that is damaged or was ever reported as lost or stolen will not be returned and will be securely destroyed to protect your personal information.

• Would you like the previous passport to be cancelled and returned to you?

Yes, please return it to me. If this box is not checked, the passport will not be returned and will be securely destroyed.

Note: If a Canadian travel document has been reported lost, stolen, damaged or is inaccessible, and has not yet expired, complete form PPTC 203, Declaration concerning lost, stolen, inaccessible, damaged or found Canadian travel document, available online at Canada.ca/passport. A Canadian travel document is no longer valid if damaged or reported as lost, stolen, or inaccessible. There is an administrative fee for the replacement of a lost or stolen Canadian travel document that has not yet expired.

Canadian provincial or territorial birth certificate	Registration number		Date of issue
Certificate of Canadian citizenship	Certificate number		Date of issue or Effective date of citizenship

BTo be completed if you were born outside of Canada.

1)Provide one (1) of the documents listed below (original only):

Certificate of Canadian citizenship		Certificate of naturalization
Certificate of registration of birth abroad		Certificate of retention of Canadian citizenship
(issued by the Registrar of Canadian Citizenship)		(issued before February 15, 1977)
Certificate number	Date of issue or Effective date of citizenship

2)To be completed if you were born outside of Canada between February 15, 1977 and April 16, 1981 inclusive (you do not need to complete this section if you are presenting a certificate of Canadian citizenship issued after January 1, 2007).

a)Are you a naturalized Canadian, i.e. did you receive Canadian citizenship following immigration to Canada?

Yes, go to section 5

No, continue to question b)

b)Was one of your parents born in Canada?

You need to provide at least one (1) document to support your identity. The identification document (ID) must be valid and be issued by a federal, provincial/ territorial government authority (or local equivalent abroad). The ID must include your name, date of birth, signature and photo. One or more document(s), when combined, may be used to fulfill these criteria.

•If you are applying in person, your original documents will be validated and returned to you.

•If applying by mail, provide copies of both sides of your ID and have them signed and dated by your guarantor. Note: The documents provided in this section must not be the proof of Canadian citizenship provided in section 4.

Signature of applicant

Date (YYYY-MM-DD)

PPTC 040 (02-2021)

Note: If insufficient space, include form PPTC 056, Additional Information – Address and Occupation, available on Canada.ca/passport.

AAddresses in the last two (2) years

Same as current home address

Different from current home address (complete below)

1.

From (YYYY-MM)

To (YYYY-MM)

City

Number

Street

Apt.

Country

Postal/ZIP code

2.

From (YYYY-MM)

To (YYYY-MM)

Number

Street

Apt.

City

Country

Postal/ZIP code

B

Occupation in the last two (2) years (check all that apply):

Ongoing occupation?

I was employed (full- or part-time)

I was in school (full- or part-time)

Other, e.g. homemaker, unemployed or retired

Enter full details below for the last two (2) years:

Employer, school or other	Address	Telephone (daytime)	Field of employment or studies	Date (from)	Date (to)

Provide the following information for two (2) persons who are neither your relatives nor your guarantor; are 18 years of age or over; and who have known you for at least two (2) years. They must agree to have their contact information provided as they may be contacted to confirm your identity. Visit Canada.ca/passport for more information on the Passport Program's definition of a relative.

Address

Number	Apt.	Street	City		Country		Postal/ZIP code
Telephone (daytime)			Telephone (other)	Email address		Has known
						me for
								Number of years
2. Surname (last name)					Given name(s)	Relationship to the applicant
Address
Number	Apt.	Street	City		Country		Postal/ZIP code

This information is helpful if you require emergency assistance while outside of Canada.

Current home address

Number Street	Apt.	City	Country	Postal/ZIP code
		Signature of applicant		Date (YYYY-MM-DD)

PPTC 040 (02-2021)

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Complete Form

ADULT ABROAD GENERAL PASSPORT APPLICATION

for Canadians 16 years of age or over applying outside of Canada and the USA

INSTRUCTIONS

Important notice: We recommend that you not finalize your 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 and reflect their identity, as determined by proof of citizenship and supporting documents.

•For Canadians under 16 years of age, use form PPTC 042, Child Abroad General Passport Application.

•Applicants who were previously issued a Canadian passport may be able to renew their passport using form PPTC 482, Adult Abroad Simplified Renewal Passport Application. To find out if you are eligible, visit Canada.ca/passport.

BTRANSLATION

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 requested in support of this application.

*A CAN$25 consular services fee is included in the above-mentioned fee. The fee is in Canadian dollars and may be converted to the local currency.

Methods of payment

Online payment is available for all passport services.

If additional passport services are required (e.g. retention of passport or an additional observation) or if you need to travel in less than

20 business days, please contact the closest Government of Canada Office abroad to confirm eligibility and fees before making payment.

Important

•Every person who requests passport services must pay the applicable fee in the exact amount.

•Applicants who cancel their application or are refused a passport are not eligible for a refund of the passport service fee. Only the consular services fee of CAN$25, applied only to adult applications, is refundable.

•Administrative fees and applicable interest will be applied to all dishonoured payments.

•Fees are subject to change.

In cases where services do not meet established service standards, applicants may be eligible for partial compensation of service fees. For information on Service Standards please visit Canada.ca/immigration-refugees-citizenship.

Submit your application at the nearest Government of Canada office that provides passport services in the country where you reside or are visiting. You can find a list of Government of Canada offices abroad online at travel.gc.ca or in your local telephone directory.

Offices authorized to process passport applications include:

•Canadian embassies;

•Canadian high commissions; or

•Canadian consulates (except those headed by honorary consuls).

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Complete Form

General information is available 24 hours a day, 7 days a week. Specific information is available at the nearest Government of Canada office that provides passport services (consult your local telephone directory).

Information on passports, fees and processing times

For travel advice and warnings or foreign entry and exit requirements (how long the passport has to be valid for travel to a foreign country), visit travel.gc.ca

Regardless of the date of travel you indicate on the application form, processing times and requirements for expedited services are still applicable. Processing times begin once a completed application form, payment and all required supporting documentation are received (see section C). Processing times do not include mailing time. Visit Canada.ca/passport for more details.

It is recommended that you do not finalize travel plans until you receive the requested passport.

The Government of Canada, or any representative of the Government of Canada will not be liable for any loss incurred as a result of or arising out of the passport not being delivered in time for you to travel on the date you have specified on the application form.

Surname (last name) and given name(s) requested to appear in passport

Write your name that you request to appear in the passport. If you are requesting a passport in a name that is different from the name that appears on the proof of citizenship, please note the following:

•For a change of surname resulting from a relationship, you must provide a marriage or common-law relationship certificate, or a document demonstrating termination of the relationship (indicating both previous and current surname).

•For a legal change of name, you must provide a Legal Name Change document/certificate, Court Order or Adoption Order displaying your old name and your new name. If you have your name legally changed, you must apply for a new travel document that accurately reflects your new name.

Additional documentation will be required to verify your identity as well as the name to appear in the passport (see section L).

All former surnames

All former surname(s) that differ from the surname requested to appear in the passport, including your surname at birth must be declared. Please separate your former surnames by a comma. These former surnames will not appear in the passport.

Mother’s surname at birth

Indicate your mother's surname (last name) at birth.

Place of birth

Your place of birth must be provided on the application form. If you do not wish the place of birth to appear in the passport, complete and submit form PPTC 077, Request for a Canadian passport without place of birth, available online at Canada.ca/passport.

Date of birth

If your proof of citizenship does not show a complete date of birth, the specific year, month and day of your birth will be entered as shown on your supporting identification (see section 5).

Sex

If the sex or gender identifier requested to appear in the passport does not match the submitted proof of Canadian citizenship or your latest travel document, complete and submit form PPTC 643, Request – sex or gender identifier on the travel document for an adult 16 years of age or older form, available online at Canada.ca/passport

Signature

You must sign your usual signature on all three (3) pages.

PPTC 040 (02-2021)

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Complete Form

Important: A Canadian provincial or territorial birth certificate does not constitute an acceptable proof of Canadian Citizenship if, at the time of your birth in Canada, one or both of your parents was or were employed in Canada by a foreign government or international agency and neither parent was a Canadian citizen or permanent resident. See subsection 3(2) of the Citizenship Act for more information. You may request a formal assessment by submitting an application for a citizenship certificate to Immigration, Refugee and Citizenship Canada (IRCC). For more details, visit the IRCC website at Canada.ca/citizenship.

The original proof of Canadian citizenship you submit with your application will be returned to you. Additional information may be requested to confirm your citizenship.

Canadian provincial or territorial certificate of birth

Only official birth documents issued by the vital statistics office in your province or territory of birth in Canada are accepted. Certain exceptions may apply. Certain Canadian provinces and territories have other documents that may also be accepted as proof of Canadian citizenship. Visit Canada.ca/passport for more information.

Note: For Canadians born in the province of Quebec, only a birth certificate or a copy of an act of birth issued after January 1, 1994, by the Directeur de l'état civil of Québec or a certificate of Canadian citizenship are accepted as proof of Canadian citizenship.

Certificate of Canadian citizenship

Commemorative certificates of citizenship are not accepted as proof of citizenship. If you require a certificate of Canadian citizenship visit the IRCC website at Canada.ca/citizenship.

A guarantor is a person other than the applicant who can confirm their identity and may be called upon to confirm personal information. A guarantor can be a relative or someone living at the applicant’s address, as long as they meet all the requirements listed below.

The guarantor must:

•be able to communicate in English or French;

•have known you (the applicant) personally for at least two (2) years. To know you personally to confirm aspects of your personal attributes.

•know you well enough to be confident that the statements you have made on the application form are true.

•be accessible to the Passport Program for verification; the Passport Program reserves the right to request a new guarantor.

The guarantor must perform the following four (4) tasks free of charge:

1.Complete or validate the information entered in the section Declaration of Guarantor (section 2).

2.The guarantor must complete the mandatory four fields: 1) I have known the applicant for (number of years), 2) signature of guarantor, 3) Date, 4) Signed at. Ensure you have completed and signed all three (3) pages of the application before submitting it to your guarantor.

3.Write "I certify this to be a true likeness of (your name)" on the back of one (1) of your photos and sign it.

4.If applicable, sign and date a copy of each document to support your identity (see section L).

The applicant must not assist the guarantor in performing their duties. If your guarantor requires assistance, contact the Passport Program. The guarantor can be either a Canadian passport holder (see section J-A below) or a member of an eligible occupation (see section J-B below).

Section J-A: Canadian passport holder, the guarantor must:

•be a Canadian citizen, 18 years of age or over;

•hold a 5-year or a 10-year Canadian passport that is valid or has expired within twelve (12) months of the date the Passport Program receives this application;

•have been 16 years of age or over when the application was submitted for the passport identified in section 2 on this application form; and

•provide the requested information contained in the passport issued in their name by completing or validating the declaration of guarantor section of the application form.

A Canadian passport holder guarantor does not need to reside in the same country as the applicant OR

Section J-B: Occupation, the guarantor must:

•currently work and/or reside within the area of accreditation served by the Government of Canada office abroad where the application is submitted; and

•be currently registered/licensed with the appropriate local authority to practice one (1) of the following professions:

• Dentist	• Lawyer or notary	• Police officer
• Medical doctor	• Notary public	• Judge
• Dean or head of university or college	• Pharmacist	• Veterinarian

• Signing officer of a bank or trust company, or of a financial institution that offers a full range of banking services (cash withdrawals, deposits, savings)

The above list is not a recognition or endorsement by the Passport Program of professional status or superior qualifications. A guarantor from the eligible list of occupations does not need to be a Canadian citizen.

Important: The applicant cannot help the guarantor in performing their duties. If the guarantor needs help they can contact the Passport Program (see section F).

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 Government of Canada office that provides passport services. The form must be completed at your expense before a person who is authorized by law to administer an oath or solemn affirmation. This may delay the processing time of the passport requested.

Enclose any Canadian travel document (passport, certificate of identity or refugee travel document) that is not expired and that is issued to you in your current name or any other name. If the travel document’s expiry date is more than twelve (12) months from the date the application is submitted, provide a written explanation as to why you are applying at this time. Should the Passport Program not be satisfied that you have an acceptable reason for applying early, your application for a new passport may be refused.

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•You need to provide at least one (1) document to support your identity. The identification document (ID) must be valid and be issued by a federal, provincial/ territorial government authority (or local equivalent abroad). The ID must include your name, date of birth, photo, and signature. If you cannot obtain ID(s) with signature because it is not issued by your jurisdiction, your ID(s) may be accepted without it. One or more document(s), when combined, may be used to fulfill these criteria.

•A Canadian passport that is expired for less than one (1) year may be used to support your identity. However, you must submit an additional piece of valid federal, provincial or territorial identification, with your passport, if:

•the passport was issued to you before you turned 16 years of age; or

•the passport was issued to you with a period of validity of less than five (5) years.

•If you are submitting copies of your ID, each side must be copied and then signed and dated by your guarantor. All original documents that you submit will be returned to you.

•If you submit copies of your documents and are using form PPTC 132, Statutory Declaration in Lieu of Guarantor, the same official who signs the declaration must also sign and date the copies of both sides of the identity document(s) to indicate that the official has seen the original(s).

Personal information provided on this form is collected by Immigration, Refugees, and Citizenship Canada (IRCC) under the authority of the Canadian Passport Order. The personal information provided will be used for the purpose of processing applications, determining entitlement to passport services and administering passport services. In the same context, the guarantor’s personal information is subject to verification and security queries to determine whether the individual meets the guarantor requirements. The personal information provided may be disclosed to other federal government institutions, provincial/ territorial governments, foreign governments, investigative bodies and/or law enforcement for the purpose of validating identity, determining current and ongoing entitlement to passport services and administering or enforcing any law or carrying out a lawful investigation.

Personal information may also be used for purposes including research, statistics, quality assurance, program and policy evaluation, internal audit, compliance, risk management, strategy development and reporting. Failure to complete the form in full may result in a delay or the application not being processed. 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. The collection, use, disclosure and retention of your personal information is further described in IRCC’s Personal Information Bank – IRCC PPU 081 and IRCC PPU 082.

You must submit two (2) identical and unaltered photo prints with each passport application. Electronic photos are not acceptable. More information is available at Canada.ca/passport.

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

•The statement "I certify this to be a true likeness of (name of applicant, written by guarantor)".

•The guarantor's signature. Note: If you are using the PPTC 132, Statutory Declaration in Lieu of Guarantor (see section J), the signing official must also sign the back of the photo.

Additional information

•Prescription glasses may be worn in photos as long as there is no glare and the eyes are clearly visible.

•The red-eye effect, tinted glasses and sunglasses make the photos unacceptable.

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

PPTC 040 (02-2021)