Nas2120b - Application For A Social Insurance Number Card Page 2
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1
2Human Resources
Développement des
Development Canada
ressources humaines Canada
INSTRUCTION SHEET
A-
Complete the application form.
B-
You must provide the original of one of the primary documents listed below, according to your status in Canada.
C-
If the name on your primary document is different from the name you are now using, you must also submit the original of one of the supporting
documents listed below.
D-
If you are replacing your SIN card, you must pay a $10.00 fee (subject to change). Make your personal cheque, bank draft or money order
payable in Canadian funds to the RECEIVER GENERAL FOR CANADA. You may pay in cash at a HRDC office. DO NOT MAIL CASH.
E-
If you are a guardian, you must submit an original document showing proof of legal guardianship in order to sign an application form on behalf of
the applicant.
If you are employed, it is important that the name and Social Insurance Number under which you are working are identical to the name and
Social Insurance Number that appear on your SIN card. This will ensure that your Canada Pension Plan and / or Québec Pension Plan
contributions are properly credited to you.
DOCUMENTS REQUIRED (subject to change)
THE DOCUMENT(S) YOU PROVIDE MUST BE ORIGINAL(S).
If you cannot obtain any of these documents, please contact us; we may be able to suggest other acceptable documents.
The information contained in the New Brunswick Vital Statistics registers and the Citizenship and Immigration Canada records will be used to
validate information that you provide on this application form when presenting a document originating from these sources.
PRIMARY DOCUMENTS
SUPPORTING DOCUMENTS
•
CANADIAN CITIZEN
PERMANENT RESIDENT
Marriage certificate, valid for surname only
Exception : A marriage certificate is not
h
Provincial birth certificate (issued in
h
Permanent Resident Card
acceptable for persons residing in
Canada by the vital statistics branch of
h
Record of Landing
Québec and who were married in that
your province or territory of birth)
h
Returning Resident Permit
st
province after April 1
, 1981.
h
Certificate of Canadian Citizenship
OTHER STATUS
•
Divorce Decree, valid for surname only
h
Work Permit / Employment Authorization
•
Legal change of name document
h
Study Permit / Student Authorization
•
Adoption papers
REGISTERED INDIAN
h
Visitor Record
h
If you are a Registered Indian and want
h
Temporary Resident Permit / Permit to
your status in Canada to be shown on your
Come Into or Remain in Canada
Social Insurance Number record as such,
h
Extension to Temporary Resident Permit /
you must provide a Certificate of Indian
Extension of Permit
Status (issued by Indian and Northern
Affairs Canada) in addition to your birth
certificate.
TO APPLY IN PERSON
We encourage you to take your application and original document(s) to the nearest Human Resources Development Canada office. Your application
will be certified and your document(s) will be returned to you immediately.
TO APPLY BY MAIL
If it is not convenient for you to apply in person, you may mail your application and document(s), and fee if applicable, to the address below. Your
document(s) will be returned with your card. PLEASE TAKE NOTE THAT WE ARE NOT ACCOUNTABLE FOR DOCUMENTS LOST IN TRANSIT.
Social Insurance Registration
If your application is in order, you should receive your Social
P.O. Box 7000
Iinsurance Number card in approximately three weeks. If you do not
Bathurst, N.B.
receive you Social Insurance Number card within this period, please
E2A 4T1
call 1-800-206-7218.
FOR MORE INFORMATION
Visit the HRDC Web site or dial toll-free 1-800-206-7218.
For general enquiries you can also contact us by e-mail at sin-nas@hrdc-drhc.gc.ca.
DETACH HERE
DETACH HERE
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Human Resources
Dé v e lo pp e me nt de s
ACKNOWLEDGEMENT OF APPLICATION
Development Canada
ressources humaines Canada
FOR A SOCIAL INSURANCE NUMBER
PROTECTED WHEN COMPLETED – A
The Employment Insurance Act requires a person to apply for a Social Insurance Number and to produce his/her Social Insurance Number card to
his/her employer within three (3) days after having received it. However, the legislation does not prevent persons from working in insurable
employment prior to being issued a Social Insurance Number and card.
HRDC OFFICE STAMP
Accordingly, this certifies that ___________________________________________________
(DO NOT use SIN Certification Stamp)
□
has applied for a first Social Insurance Number.
□
has applied for a replacement card of Social Insurance Number _________________________.
When the application is approved, the Social Insurance Number card will be sent to the address
specified by the applicant at the time of his/her application.
Initials
Date
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