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Application Form for Permanent Residence in Canada

 
Warning with reading before filling the form:

1) Do not fill this form if you do not have a minimal educational level equivalent Bachelor’s degree or more (Master’s degree, Ph. D) + at least 04 years of work or training courses and financial means to assume your project of immigration in Canada.

2) You must also send the fees: $150 American dollars or $150 Canadian dollars or 100 Euros.

You must make your payment ONLY by Electronic Funds Transfer (EFT) using the SWIFT system through our bank account in Canada.
  
Here are the exact transaction details:

Bank : ROYAL BANK OF CANADA (RBC), N°5, Complexe Desjardins,
          Montreal, H5B 1B4, Canada.
Account Number : 5253018
Transit Number: 05181
RBC Number: 003
Code Swift Number : ROYCCAT2
American Routing Number (ABA) : 021000021
For the account of : Mr. DAHO MOKHTAR, Lawyer
Corresponding bank in USA : JP MORGAN CHASE BANK, New-York

All bank transfer charges are to be paid by you.
You will have to add 20 Euros to the overall charges.
Please, notify us by email once transfer is done.

 

 


 

Family name
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Given name(s)
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E-mail address
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Retype your E-mail address
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Your country
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Mailing address

 

 

 

 

 

Your residential address

 

 


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Mailing address (include city and country:

Your residential address, if different from your mailing address:


 

Telephone at home
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Country code-Area code-Number
Alternative Phone Number
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Family name - as shown in your passport or travel document
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Given name(s)
as shown in your passport
or travel document
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Sex
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 Male       Female
Place of birth
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Town/City 

Country  

Your country of citizenship
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Your native language
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Your height
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 cm      OR         ft   in. 
Colour of your eyes
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Your current marital status

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Never married       Married       Widowed 

Annulled marriage  Divorced    Common-law

If you are married or in common-law relationship, provide the date on which your were married or entered into the common-law relationship
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Day      Month     Year    
Have you previously been married or in a common-law relationship?
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Yes    No
If Yes, give the following details each previous spouse or partner. If you do not have enough space, provide details on a separate sheet of paper.

Name of previous spouse or partner

Date of birth
Day     Month    Year

Type of relationship
Marriage       Common-law union

From :
Day     Month   Year  
To :   
Day     Month   Year  

Can you communicate ...


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in Englsh ?  Yes    No

in French ?  Yes    No

 

Education

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How many years of formal education do you have?

What is your highest level of completed education?

No secondary        Secondary

Trade/Apprenticeship

Non-University Certificate/diploma

Bachelor’s degree   Master’s degree   Ph D

 

Your current occupation

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Where do you intend to live in Canada?


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   City/Town 

Province
Details of all the secondary and post secondary education
 

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Give full details of all the secondary and post secondary education (including university, college and apprenticeship training) you have had: (From/to; Name of institution; City and country; Type of certificate or diploma issued)

 
Your work experience
  

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Starting with your current occupation, list your occupations within the last ten (10) years

 
 

   

Details of family members:
  
Spouse or common-law partner:

Family Name
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Given name
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Sex
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 Male       Female
Place of birth
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Date of birth
Day      Month     Year    

Town/City 

Country  

Education

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How many years of formal education do you have?

What is your highest level of completed education?

No secondary       Secondary

Trade/Apprenticeship

Non-University Certificate/diploma

Bachelor’s degree   Master’s degree   Ph D

 

Work experience
  
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Starting with your current occupation, list your occupations within the last ten (10) years

 
     

   

Details of family members:
  
Children: You must provide the following details about your dependent children, whether they will be accompanying you to Canada or not. Indicate their name, first name, their age and their occupation:

How many children? 
   How many children do you have?   
Child-1
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Family name

Given name

Male       Female

Date of birth
Day      Month     Year    

Town/City 

Country  

 

Child-2
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Family name

Given name

Male       Female

Date of birth
Day      Month     Year    

Town/City 

Country  

  
Child-3
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Family name

Given name

Male       Female

Date of birth
Day      Month     Year    

Town/City 

Country  

  
Others 
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Study in Canada
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Have you or, if applicable, your accompanying spouse or common-law partner, previously completed a program of full-time study of at least two years at a post-secondary institution in Canada ? Yes    No

You ?  Yes    No

Your spouse or common-law partner ?  Yes    No
  
Work in Canada
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Have you or, if applicable, your accompanying spouse or common-law partner, previously worked full-time in Canada?
Yes    No

You ?  Yes    No

Your spouse or common-law partner ?  Yes    No
  
Parents in Canada 
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Do you or, if applicable, your accompanying spouse or common-law partner, have a relative living in Canada who is a citizen or a permanent resident of Canada?
Yes    No

You ?  Yes    No

Your spouse or common-law partner ?  Yes    No

Relationship:
Mother or father    Grandmother or grandfather

Granddaughter or grandson     Sister or brother

Niece or nephew          Aunt or uncle

Spouse or common-law partner

Other
 
Funds 
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Amount of unencumbered transferable and available funds you have, in Canadian dollars:   $

     
 
  FOR BUSINESS IMMIGRANT ONLY :
       
Indicate which class
you are applying under
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Investor    Entrepreneur

Self-Employed Persons

Business
exploration trip
 
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Have you made a business exploration trip to Canada in the five years preceding the date of your application?
Yes    No
 
Give details:

Business immigration
initiatives
 
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Have you participated in business immigration initiatives administered jointly by the federal and provincial governments of Canada?   
Yes    No
 
Give details:

Business ownership
 
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Give details for type of ownership, type of business, etc.:

For investor class
applicant only:
experience in
business
management
 
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Give details:

For the self-employed
persons class only:
your experience

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Indicate the number of years of full-time relevant experience you have in the period of last five years: 

Give details:

Intended occupation: describe the occupation in which you intend to be self-employed. Provide details of location and anticipated investment (if applicable):
     
   NET WORTH
   (in Canadian dollars)  
  
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Bank deposits:

Real property:

Publicly traded stocks and other investments :

Immigrant investor program investment
(investor applicants only) :

Business :

Pensions and other assets :

Liabilities :

Other personal debts :

Net worth :

 

      Total funds available for settlement in Canada:
                          

  
   


Please fill this form completely. As of reception of the form and the necessary payment (150 Canadian dollars or 150 American dollars or 100 Euros), my cabinet will forward to you quickly the answer: file and complete information. You can send your request by D.H.L. International, accompanied by all the necessary documents (complete and detailed curriculum vitae, copy of the diplomas and certificates of work (same documents for the spouse, if married and payment of the fees). Otherwise, your request will be rejected. It is thus useless to contact us if you are not able to meet these conditions.

Very important remark: a significant number of e-mail addresses sent to us are incorrect and thus result in bounced responses. If you do not receive a response in the 24 hours, it is because your e-mail address is quite simply not valid!!! Thus correct the situation so that the communication is restored quickly!!!. It is frequent that provider Caramail, Yahoo, etc. is broken down!!! and does not transmit the messages!!!. In this case, it is necessary to send your request by D.H.L. International: it is more reliable and takes five days to arrive in Canada!!!

 

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