Application For Criminal Rehabilitation - Citizenship And Immigration Canada Page 4

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16
17
Reviewing officer's
►
recommendation
I concur / approve
I do not concur / approve
18 Comments
19 Name of reviewing officer
20 Signature of reviewing officer
Date (YYYY-MM-DD)
21 List of documents or photocopies attached - check those attached
Passport
Driver's License and USA Birth of Certificate (USA-born citizens only)
Court judgement(s)
Text of non-Canadian statutes
Police certificate
Documentation re: sentence, parole, probation, fine or pardon
Documentation re: juvenile offender
Other documentation (specify)
I certify that a copy of these documents has been provided to the applicant and that the applicant has been given an opportunity to provide
comments.
22 Name of officer
23 Signature of officer
Date (YYYY-MM-DD)
SECTION D
FOR OFFICE USE ONLY
Initials
Date (YYYY-MM-DD)
Notification by (fax/e-mail) received that authority from the Minister for
►
Granted
Refused
relief under A36(1)(b) or A36(1)(c) was:
Date (YYYY-MM-DD)
Authority from the Minister's delegate for relief under A36(2)(b) or
►
Yes
No
A36(2)(c) granted
Name (please print)
Title
SIGNATURE
Date (YYYY-MM-DD)
IMM 1444 (08-2012) E

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