Pptc 153 Form 2015

Years Signature of guarantor Date Aussi accessible en fran ais PPTC 153 2015-05 R1 - Page 1 of 7 Previous Canadian Travel Document see Instructions section J Has a Canadian travel document passport certificate of identity or refugee travel document been issued to you No Yes specify If the passport is still valid include it with your application. Would you like the previous passport returned to you If not it will be securely destroyed by Passport Program to protect your Yes please return the previous passport to me. Read Instructions Protected B when completed for Canadians 16 years of age or over applying in Canada or from the USA Adult General Passport Application 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 or the refusal of passport services and may be grounds for criminal prosecution. Your application will not be processed if you fail to complete all of the required sections of this form and/or refuse to consent to the exchange or disclosure of any personal information required for the delivery of passport services. However the head covering must not cast shadows on the face and the full face must be clearly visible. More information is available at passportcanada.gc.ca. N Privacy Notice Statement All personal information provided on this application form is collected by Passport Program Citizenship and Immigration Canada CIC for the purpose of determining entitlement of the applicant to a Canadian passport and to provide information to the Consular Operations Bureau of Foreign Affairs Trade and Development Canada in the event that the passport holder requires assistance while travelling abroad. In the performance of those services personal information is collected used and disclosed under the authority of the Canadian Passport Order and in accordance with the Privacy Act and any other federal laws regulations and policies applicable to the protection of of the delivery of passport services CIC and other federal government institutions or Government of Canada offices abroad assisting in maintain the integrity of the Passport Program all personal information collected is subject to verification and security queries to authenticate identity and citizenship as well as to identify the existence of grounds for refusal to issue a passport the revocation of a currently valid passport or the refusal of passport services. In the same context the guarantor s personal information is also subject to verification and security queries to determine whether the individual meets the guarantor requirements. 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. However the head covering must not cast shadows on the face and the full face must be clearly visible. More information is available at passportcanada.gc.ca. N Privacy Notice Statement All personal information provided on this application form is collected by Passport Program Citizenship and Immigration Canada CIC for the purpose of determining entitlement of the applicant to a Canadian passport and to provide information to the Consular Operations Bureau of Foreign Affairs Trade and Development Canada in the event that the passport holder requires assistance while travelling abroad. In the performance of those services personal information is collected used and disclosed under the authority of the Canadian Passport Order and in accordance with the Privacy Act and any other federal laws regulations and policies applicable to the protection of of the delivery of passport services CIC and other federal government institutions or Government of Canada offices abroad assisting in maintain the integrity of the Passport Program all personal information collected is subject to verification and security queries to authenticate identity and citizenship as well as to identify the existence of grounds for refusal to issue a passport the revocation of a currently valid passport or the refusal of passport services. Complete and sign the Declaration of Guarantor section 2 ensure you have completed and signed all three 3 pages of the application before submitting it to your guarantor. 2. Write I certify this to be a true likeness of your name on the back of one 1 of your photos and sign it. 3. If applicable sign and date a copy of each document to support your identity see section L. Program. 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 Passport Program regional office in Canada or any Government of Canada office in the USA. Note If you are anticipating a change of name in the near future a new complete general passport application with fees will need to be submitted. Complete if different from the surname last name to appear in the passport for Passport Program Citizenship and Immigration Canada information only it will not appear in the passport. 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. Provide original or copies signed and dated by your guarantor of any supporting identification showing this date 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 passportcanada.gc.ca. Signature You must sign your usual signature on all I A guarantor is a person other than yourself who confirms your identity. For Canadians under 16 years of age use form PPTC 155 Child General Passport Application. Applicants who were previously issued a Canadian passport may be able to renew their passport using form PPTC 054 Adult Simplified Renewal Passport Application. To find out if you are eligible visit passportcanada.gc.ca. B Requirements Checklist All three 3 pages of the application form completed and signed within the last twelve 12 months Two 2 identical unaltered passport photos taken within the last six 6 months Application form and one of the photos certified by your guarantor Any valid Canadian travel document passport certificate of identity or refugee travel document issued in your name The fee Note 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. Fee and Period of Validity Where the application is made in Canada and the passport is to be delivered in Canada to be delivered to the USA 5-year validity Can 120 A Can 25 consular fee is included in the above-mentioned fee. Includes Bermuda American Samoa the Midway Islands Puerto Rico and the US Virgin Islands. There is a separate non-refundable Can 45 administrative fee for the replacement of a valid lost or stolen Canadian travel document. Issued to Canadian citizens only a Canadian passport reflects the identity of the applicant as determined by documentary evidence of citizenship and documents to support identity. For Canadians under 16 years of age use form PPTC 155 Child General Passport Application. Applicants who were previously issued a Canadian passport may be able to renew their passport using form PPTC 054 Adult Simplified Renewal Passport Application. To find out if you are eligible visit passportcanada.gc.ca. B Requirements Checklist All three 3 pages of the application form completed and signed within the last twelve 12 months Two 2 identical unaltered passport photos taken within the last six 6 months Application form and one of the photos certified by your guarantor Any valid Canadian travel document passport certificate of identity or refugee travel document issued in your name The fee Note 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. Fee and Period of Validity Where the application is made in Canada and the passport is to be delivered in Canada to be delivered to the USA 5-year validity Can 120 A Can 25 consular fee is included in the above-mentioned fee.