Imm 5440 2009-2026

Settlement Needs START-UP COSTS Clothing Furniture Start-up costs household effects bedding and linens School start-up costs Food staples Hook-up costs rent deposit telephone utilities etc. MONTHLY EXPENDITURES Shelter Transportation public transit Living allowance food incidentals etc. SETTLEMENT ASSISTANCE Meet the refugee s at the airport and provide transportation to the final destination Locate an interpreter if applicable Apply for provincial health plan and Interim Federal Health plan Apply for Social Insurance Number Select a family physician Select a dentist Plan for medical emergencies Provide orientation public transportation banking services etc. Provide assistance in linking refugee s with community activities Enroll children in school if applicable Make child care arrangements if applicable Register for child tax benefit if applicable Enroll adults in language training IMM 5440 10-2009 E DISPONIBLE EN FRAN AIS - IMM 5440 F SAH CG Cosponsor 1 individual organization C - SETTLEMENT NEEDS - DETAILS Print details of plans your group has made or intends to make to help the refugee s settle. Citizenship and Immigration Canada Citoyennet et PROTECTED WHEN COMPLETED - B PAGE 1 OF 2 FOR CIC USE ONLY SETTLEMENT PLAN CIC file identification no. SPONSORSHIP AGREEMENT HOLDER OR CONSTITUENT GROUP Principal applicant ID no. REFER TO THE INSTRUCTION GUIDE FOR INFORMATION ON THIS FORM. A - GENERAL INFORMATION 1 Name of principal refugee applicant Surname Date of birth Given name s Year Month Day 2 Name of sponsorship agreement holder SAH 3 Name of constituent group CG if applicable 4 Name of cosponsor - Individual if applicable 6 Name of designated main contact person 7 Mailing address no. street City Province 8 Home telephone no. Area code No* Postal code Work or cell telephone no. Facsimile no. Ext. 9 Name of alternate contact person E-mail address Telephone no. B - SETTLEMENT CHECKLIST Identify who will be providing for the settlement needs by checking the relevant box note more than one party may provide for the same need. If you require more space add a page. 1. What accommodation temporary or permanent arrangements are available 2. Indicate the names of people who will be volunteering to assist with the refugee applicant s settlement and the tasks they will be assisting with. 3. a Which immigrant settlement assistance agencies will the refugee applicant s likely access b Have you contacted these agencies for information on available services Specify Yes No 4. Describe the anticipated monthly expenses for the refugee applicant s 5. If your group plans to use in-kind donations to support part of this sponsorship provide details. 6. What contingency plans has your group made in case problems arise with the implementation of this plan 7. Applicable only where cosponsors have signed the undertaking. Provide further details on how the sponsor and cosponsor s plan to share settlement responsibilities. D - SIGNATURES Constituent Group Representative if applicable DATE Cosponsor - Organization if applicable Cosponsor - Individual if applicable Sponsorship Agreement Holder Representative The information you provided on this form is collected under the authority of the Immigration and Refugee Protection Act and will be used to maintain a record of application and sponsorship undertakings by Sponsorship Agreement Holders and Constituent Groups in Canada according to the requirements of the Act.