PPTC 203: Declaration Concerning a Lost, Stolen, Inaccessible, Damaged or Found Canadian Travel Document

Type or print in capital letters using black or dark blue ink.

Under Personal information as indicated on most recent Canadian travel document, mark My name or Child's name for: The Canadian travel document was issued in.

Enter the Surname (last name) and the Given name(s).

Enter the Sex and the Date of birth (YYYY-MM-DD).

Under Place of birth, enter the City, the Country or Territory and the Prov./Ter./State (if applicable).

Enter the Document number (if known) and the Date of issue (if known) (YYYY-MM-DD).

Under Place of issue (if known), enter the City and the Country or Territory.

Under Signed at, enter the City and the Country or Territory; then sign on the Signature of applicant line and enter the Date (YYYY-MM-DD).

Is the Canadian travel document being submitted with your declaration? Mark No and continue to section 2, or mark Yes and continue to section 3.

Provide in section 2 why the Canadian travel document listed in section 1 is no longer in your possession, with a detailed explanation as to why you are not submitting the Canadian travel document and what has happened to it.

Incomplete descriptions may result in the delay or refusal of your application. If insufficient space, attach a separate signed and dated sheet.

Explain the efforts you have made to recover this Canadian travel document.

Enter the date this Canadian travel document was lost, stolen or became inaccessible (YYYY-MM-DD).

Enter the Date this Canadian travel document was last used on (YYYY-MM-DD) and its Location: the City and the Country or Territory.

Mark Yes or No for Was a police report filed? and for Has travel document been seized/surrendered*? If you answered 'yes' to either question complete section A and B. If you answered 'no' to both questions complete section B.

A seized/surrendered travel document is any Canadian passport, Refugee Travel Document or Certificate of Identity (including, but not limited to a valid or expired travel document) that has been confiscated by either a domestic or foreign government law enforcement authority or ordered surrendered by a court of law.

In Section A, enter the Date (YYYY-MM-DD), the Report or file number and the Name of law enforcement authority.

In Section B, provide the reason for not filing a police report OR details and any documents related to the events of the seizure/surrender.

Mark Yes or No for Were any other provincial or federal identification documents lost or stolen?

In section 3, enter the Detailed circumstance of how the Canadian travel document was damaged or found.

Explain why you are applying for a replacement Canadian travel document.

Enter the date the Canadian travel document was damaged or found (YYYY-MM-DD) and its Location: the City and the Country or Territory.

DECLARATION: you solemnly declare that, to your knowledge, the statements made in this declaration are true.

In section 4, enter your Surname (last name), Given name(s), Daytime telephone number and Date of birth (YYYY-MM-DD).

In section 4, sign on the Signature of applicant line, enter the Date (YYYY-MM-DD) and, under Signed at, enter the City and the Country or Territory.

You declare that you have read and understood the WARNING to applicant at the top of page 1.

PPTC 203 is the Declaration concerning a lost, stolen, inaccessible, damaged or found Canadian travel document. A Canadian travel document application form must also be completed if a replacement Canadian travel document is required.

Any false or misleading statement on this form or relating to any document in support of your Canadian travel document application, including concealment of any material fact, may lead to refusal to issue or revocation of a Canadian travel document and be grounds for criminal prosecution.