Form Cit 0001 - Application For A Citizenship Certificate For Adults And Minors - Immigration, Refugees And Citizenship Canada Page 3

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5
If you are a woman and married before January 1, 1947, answer the following questions. If you married on or after January 1, 1947,
this question does not apply to you. Go to part 6.
Husband's surname/last name
Information on
your husband
(Provide details of every
Given name(s)
marriage before 1947.)
YYYY - MM - DD
Date of
Husband's country of birth
birth
YYYY - MM - DD
Date of
Country of marriage
marriage
Is your husband a
No
Yes
by birth
or other
Canadian citizen?
Number on husband's
YYYY - MM - DD
citizenship certificate (if
Date
applicable)
Use another piece of paper if you need more space to list other marriages.
6
Other nationalities
Are you a citizen of one or more countries other than Canada?
No
Yes
If yes, list the country or countries, date and how you obtained this citizenship.
Absences from Canada
Give details
No
Yes
Did you leave Canada for 1 year or longer before 1977?
below
FROM
TO
DESTINATION
REASON
YYYY - MM - DD
What country did you go to?
Why did you go to this country?
YYYY - MM - DD
7
Telephone number(s) Home
Work
Ext.
Cell
E-mail address
(if applicable)
Home address
Postal code
Mailing address
(if different from home
address)
Postal code
CIT 0001 (04-2016) E

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