Application For Criminal Rehabilitation - Citizenship And Immigration Canada

Download a blank fillable Application For Criminal Rehabilitation - Citizenship And Immigration Canada in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Application For Criminal Rehabilitation - Citizenship And Immigration Canada with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Citizenship and

Citoyenneté et

PROTECTED WHEN COMPLETED -

Immigration Canada

PAGE 1 OF 4

Language of correspondence

APPLICATION FOR CRIMINAL REHABILITATION

English

French

SECTION A

TO BE COMPLETED BY APPLICANT

APPLICATION FOR APPROVAL OF REHABILITATION

FOR INFORMATION ONLY

SECTION B

TO BE COMPLETED BY APPLICANT

Family name

Given name(s) - Do not use initials

Date of birth (YYYY-MM-DD)

Country of birth

Citizenship

Sex

Male

Female

Marital status

Single

Married

Common-law

Widowed

Divorced

Separated

All other names that I use or have used (Include maiden name, previous married name(s), aliases and nicknames, legal change of name)

1) Family name

Given name(s)

2) Family name

Given name(s)

My home address is

No. & street

Apt./Unit

City/Town

Province / State / Country

Postal / ZIP code

Mailing address

All correspondence should be mailed to box 8

or to:

No. & street

Apt./Unit

City/Town

Province / State / Country

Postal / ZIP code

Time

Home telephone no.

Business telephone no.

Fax no.

13 Indicate most convenient time

to reach you by telephone

E-mail address (Indicating an e-mail address will authorize all correspondence, including file and personal information, to be sent to the e-mail address you

specify.)

15 I may be inadmissible to Canada because of the following offence(s): (use a separate sheet if necessary, entitled #15: Offences / Convictions)

DATE(S) OF OFFENCE(S)/

STATUTE

OFFENCE(S)/CONVICTION

CONVICTION

PLACE OF OFFENCE(S)/CONVICTION

SENTENCE(S)

NUMBER(S)

(YYYY-MM-DD)

On a separate sheet of paper, explain in detail the events/circumstances leading to the offence(s)/conviction(s). Indicate #16: Events / Circumstances on

the sheet of paper.

WARNING

DETAILS OF ALL OFFENCES AND CONVICTIONS MUST BE ACCURATELY RECORDED ON THIS DOCUMENT. PROVIDING FALSE OR MISLEADING

INFORMATION WILL LIKELY RESULT IN A REFUSAL OF YOUR APPLICATION AND MAY PERMANENTLY BAR YOUR ADMISSION TO CANADA.

This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants.

IMM 1444 (08-2012) E

(DISPONIBLE EN FRANÇAIS - IMM 1444 F)