申请表版本:IMM 1436 (06-2020) E
加拿大移民部(IRCC)网站最新版文件下载地址:imm1436e.pdf(在打开后的页面使用鼠标右键选择“另存为”,保存到本地)
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RREQUEST TO AMEND VALID TEMPORARY RESIDENT DOCUMENTS OR INFORMATION CONTAINED IN THE CONFIRMATION OF PERMANENT RESIDENCE
要求修改有效的临时居民文件或永久居留确认书中包含的信息
PART A - PERSONAL DETAILS CONTAINED ON YOUR VALID TEMPORARY RESIDENT DOCUMENTS OR CONFIRMATION OF PERMANENT RESIDENCE
A部分:有效临时居民证件或永久居留确认书上包含的个人详细信息
问题1. Client ID number/UCI - 个人Client ID 或 UCI 号(如果没有,请留空)(注:此部分可以参考 Client ID 和 UCI)
问题2. Surname(s) (Family name) (As it currently appears on your document) - 姓氏(当前你的文件上所显示的)
问题3. Given name(s) (As it currently appears on your document) - 名字(当前你的文件上所显示的)
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问题4. Other name(s) used - 其他曾用姓(指出曾经使用的所有其他姓氏,包括不同的拼写并做出解释。 例如:“Smith”(birth name/maiden name - 出生名称/婚前姓名),“Leroux”(婚后名 - former married name))
问题5. Other given name(s) used - 其他曾用名(包括不同的拼写并做出解释。 例如:'Maggie'(昵称 - nickname))
问题6. Gender - 性别
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- F - Female(女)
- M - Male(男)
- U - Unknown(未知)
- X - Another gender(其他性别)
注意:如果你选择性别为 F 或 M,则必须与自己提交申请时的提供的护照或旅行文件上所标注的性别一致。如果选择的性别标识符是 X,则应匹配等效的非男女二元选项(equivalent non-binary option)。
(时光在路上(www.timezls.com) 注:关于X 性别的背景资料,请参考如下文章:
)
问题7. Date of birth (YYYY-MM-DD) - 出生日期(年-月-日)
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问题8. Place of birth (City, state/province and country or territory) - 出生地(城市、州/省 以及 国家/地区)
问题9. Citizenship - 公民身份,如果双重国籍,选择入境加拿大时所使用护照上的
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问题10. Passport number - 入境时所使用的护照的护照编号,如果没有此护照副本,写当前护照的编号,并在下面勾选相应的选项
Indicate if: - 选择属于哪种情况
- On entry - 入境时所使用的护照
- Current - 当前护照
问题11. Date of issue (YYYY-MM-DD) - 签发日期(年-月-日)
问题12. Expiry date (YYYY-MM-DD) - 过期日期(年-月-日)
问题13. Marital status - 婚姻状态
- Never married - 未婚(从没结过婚)
- Married - 已婚
you are married, is your spouse a Canadian citizen or permanent resident? —— Yes /No - 如果已婚,配偶是否时加拿大公民或永久居民? - Widowed - 丧偶
- Separated - 分居(已婚,但不与配偶同住)
- Divorced - 离异(正式分居并合法地结束了婚姻)
- Common-law partner - 同居伴侣(与伴侣属于同居关系,至少一起生活了一年。注:参考此处。)
问题14. Language of correspondence - 通信语言
- English - 英语
- French - 法语
问题15. Current mailing address - 通信地址
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- P.O. box - 邮箱号
- Apt./Unit - 公寓或单元号码
- Street no. - 街道号
- Street name - 街道名
- City/Town - 市/乡镇
- Country - 国家/地区
- Province/State - 省/州
- Postal code - 邮编
- District - 区
问题16. Residential address Same as mailing address? —— Yes/No - 居住地址是否与上述通信地址相同?如果不同,填写如下信息
- Apt./Unit
- Street no.
- Street name
- City/Town
- Country
- Province/State
- Postal code
- District
问题17. Telephone no. - Canada/US - Other - 电话号码 - 加拿大/美国 - 其他
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- Type - 类型
- Residence - 住宅
- Cellular - 手机
- Business - 办公
- Ext. -分机号(如果有)
- No. - 具体号码
- Country Code - 国家代码
问题18. Alternate Telephone no. - Canada/US - Other - 备用电话号码 - 加拿大/美国 - 其他
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- Type
- Residence
- Cellular
- Business
- Ext.
- No.
- Country Code
问题19. 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.) - 电子邮件izhi(提供电子邮件地址表示授权将所有通信(包括文件和个人信息)发送到该指定的电子邮件地址)
问题20. Date of original entry (YYYY-MM-DD) - 首次入境加拿大的日期(年-月-日)
问题21. Date permanent residence or temporary residence was granted (YYYY-MM-DD) - 永久居留或临时居留授予日期(年-月-日)
PART B - INFORMATION TO BE AMENDED
B部分:要修改的信息
问题1. Please indicate for which of the following you need a correction. If you have more than one valid temporary resident document, indicate the document ID number or if unknown, the document issue date and expiry date of the requested document. -
指出需要更正以下哪项。 如果有多个有效的临时居民文件,请指明文件ID号,如果不清楚,填写所请求文件的文件签发日期和失效日期。
- Confirmation of permanent residence (or record of landing) - 永久居留确认文件(或登陆记录)
- Exclusion Order - 排除令
- Departure Order - 离境令
- Authorization to Return to Canada - 授权可以返回加拿大(参考此文)
- Permit to Come Into or Remain in Canada - Temporary Resident Permit - 允许进入或留在加拿大 - 临时居民许可
- Protected Person - 受保护人士
- Work Permit - 工签
- ID No.: __________________ - ID 号
OR 或
- Issue date: (YYYY-MM-DD) and Expiry date: (YYYY-MM-DD) - 签发日期:(年-月-日)以及失效日期:(年-月-日) - Study Permit - 学习许可
- ID No.: __________________ - ID 号
OR 或
- Issue date: (YYYY-MM-DD) and Expiry date: (YYYY-MM-DD) - 签发日期:(年-月-日)以及失效日期:(年-月-日) - Visitor Record - 访客记录
- ID No.: __________________ - ID 号
OR 或
- Issue date: (YYYY-MM-DD) and Expiry date: (YYYY-MM-DD) - 签发日期:(年-月-日)以及失效日期:(年-月-日)
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—— 第 2 页 ——
问题2. 此处内容同前面雷同,不再赘述
Surname(s) (Family name)
问题3. Given name(s)
问题4. Date of birth (YYYY-MM-DD)
问题5. Place of birth (City, state/province)
问题6. Country of birth
问题7. Citizenship
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问题8. Gender
- F - Female(女)
- M - Male(男)
- U - Unknown(未知)
- X - Another gender(其他性别)
注意:如果你选择性别为 F 或 M,则必须与自己提交申请时的提供的护照或旅行文件上所标注的性别一致。如果选择的性别标识符是 X,则应匹配等效的非男女二元选项(equivalent non-binary option)。
(时光在路上(www.timezls.com) 注:关于X 性别的背景资料,请参考如下文章:
)
问题9. Marital status
- Never married
- Married
- Common-law partner
- Widowed
- Divorced
- Separated
问题 10. Date of original entry (YYYY-MM-DD) - 首次入境日期(年-月-日)
问题11. Date permanent residence or temporary residence was granted (YYYY-MM-DD) - 永久居留或临时居留授予日期(年-月-日)
问题12. Other change (Provide a description in PART C, section 2 below) - 其他变更(在C部分的第二栏给出解释)
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PART C - C 部分
问题1. If you are applying for an amendment to your confirmation of permanent residence (or record of landing) and you are not a Canadian citizen, have you, since your admission to Canada as a permanent resident, been convicted of a crime or offence in Canada or elsewhere? —— Yes/No
如果你正在申请修改自己的永久居留确认书(或登陆记录),并且不是加拿大公民,那么自从你作为永久居民入境加拿大以来,是否在加拿大或其他地方被判犯有犯罪或违法行为?—— 是/否
If yes, attach copies of the relevant court documents - 如果回答Yes,请附法院的相关文件。
问题2. Reasons for requesting the amendment(s). (Attach another sheet if you need more space.) - 请求修改的原因(如果需要更多空间,可以另外附上一页)
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STATEMENT - 声明
I certify that the statements made on this application document are true and correct. I understand that the approval of my request to amend my date of birth may affect my eligibility for benefit and services from other government institutions as that term is defined in the Privacy Act and may also result in the recovery from me by other government institutions of payments or benefits made to me under income support programs for which I was not eligible at the time the payments or benefits were paid.
我保证本申请文件中的陈述真实无误。我对此了解:对我修改出生日期的请求的批准可能会影响我获得其他政府机构的福利和服务的资格,因为在《隐私法》中对该条款的规定,也可能影响其他政府支付机构从我这里恢复 或者通过收入支持项目向我支付的福利,导致向我付款或提供福利时我不具有资格。
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Signature _________________________ - 签名
Date (YYYY-MM-DD) _________________________ 日期(年-月-日)
Personal information provided on this form is collected by Immigration, Refugees, and Citizenship Canada (IRCC) under the authority of the Immigration and Refugee Protection Act (IRPA). The personal information will be used for the purpose of processing an application. The personal information provided may be disclosed to other federal government institutions, law enforcement bodies, non-governmental organizations, provincial/territorial governments and foreign governments for the purpose of validating identity, admissibility and eligibility.
本表格中提供的个人信息由加拿大移民、难民和公民部(IRCC)根据《移民及难民保护法》(IRPA)的授权收集。个人信息将用于处理申请。所提供的个人信息可能会披露给其他联邦政府机构,执法机构,非政府组织,省/地区政府和外国政府,以验证身份,是否可入境和资格。
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Personal information may also be used for other purposes including research, statistics, program and policy evaluation, internal audit, risk management, subsequent program eligibility, strategy development and reporting.
个人信息还可能用于其他目的,包括研究、统计、计划和政策评估、内部审计、风险管理、后续项目资格、战略制定和报告。
Failure to complete the form in full may result in a delay or the application not being processed. The Privacy Act gives individuals the right of access to, protection, and correction of their personal information. If you are not satisfied with the manner in which IRCC handles your personal information, you may exercise your right to file a complaint to the Office of the Privacy Commissioner of Canada. The collection, use, disclosure and retention of your personal information is further described in IRCC’s Personal Information Bank – IRCC PPU 042.
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未能完整填写表格可能会导致延迟或申请无法处理。《隐私法》赋予个人访问、保护和更正其个人信息的权利。如果你对 IRCC 处理你的个人信息的方式不满意,可以行使向加拿大隐私专员办公室提出投诉的权利。IRCC 的个人信息库 – IRCC PPU 042 中进一步描述了个人信息的收集、使用、披露和保留等内容。
—— 第 3 页 ——
DOCUMENT CHECKLIST - 文件核对表
Ensure the following documents are included with your application. Check √ each box once you enclose the item. Failure to provide a fully completed application or the necessary documents will result in the return of your application. Please make sure you complete this document and include it in your application as the cover page. Submit photocopies of documents unless we ask for originals as they will not be returned to you.
确保申请中包含下列文件。一旦你附上文件,请勾选复选框。不提供完整申请或必要文件,申请将会被退回。请确保填写此文件并把其作为申请的封面。除非被要求,否则不要提供文件复印件,因为复印件将不会退还给你。
I HAVE ENCLOSED THE FOLLOWING ITEMS: - 我已经附上下列文件
(See "Gather documents" section in the Instruction Guide for examples) - (可查看指南中“收集文件”部分的举例)
- OriginalRequest to Amend Valid Temporary Resident Documents or Information contained in the Confirmation of Permanent Residence completed and signed.
填完并签字的《请求修改有效的临时居民文件或永久居留确认书中包含的信息》表格原件。 - Photocopy of federal or provincial/territorial government issued photo identification OR if unavailable, photocopy of government issued or internationally recognized photo identification from outside Canada prior to your entry to Canada. (See "Gather Documents" section in the Instruction Guide for examples)
联邦或省/地区政府签发的带照片的身份证明文件 或 如果没有前者,提供入境加拿大之前,加拿大境外其他国家政府签发的或国际认可的带照片的身份证明文件复印件(可查看指南中“收集文件”部分的举例) - Photocopy of another form of government issued or internationally recognized identification from outside Canada before your entry to Canada indicating an error was made. (See "Gather Documents" section in the Instruction Guide for examples)
在你入境加拿大之前,由加拿大境外政府签发的或国际认可的身份证明文件复印件,上面存在的错误信息已做标示(可查看指南中“收集文件”部分的举例) - Photocopy of letter of acceptance or enrolment from your current designated learning institution, if applicable.
来自指定院校的录取通知书或入学通知书复印件,如果适用的话 - Copies of court documents if you have been convicted of a crime since becoming a permanent resident (if you are not a Canadian citizen).
成为加拿大永久居民后(如果你不是加拿大公民)被定罪,提供法院的文件副本 - Original Use of a Representative (IMM 5476) form completed and signed, if applicable
代理人信息表(IMM 5476)(完成并签字)原件,如果适用的话 - Proof of urgency, if applicable. - 紧急情况证明(如果适用的话)
IMMIGRATION DOCUMENT CONTAINING ERROR - 移民文件有误
- OriginalWork Permit, Study Permit, Visitor Record or Permit to Enter and Remain in Canada (IMM 1442, IMM 1208, IMM 1102, IMM 1097 or IMM 1263).
工签、学签、访客记录或入境并在加拿大停留许可(IMM 1442、IMM 1208、IMM 1102、IMM 1097 或 IMM 1263)原件 - Photocopy of the Record of Landing (IMM 1000) or Confirmation of Permanent Residence (IMM 5292 or IMM 5688).
登陆记录 (IMM 1000) 或永久居留确认文件(IMM 5292 或 IMM 5688) 复印件
Mail your completed application form and all required documents to:
把你的完整的申请表和所有要求的文件邮寄到:
Request to amend Valid Temporary Resident Documents or Information contained in the Confirmation of Permanent Residence
Operations Support Centre (OSC)
PO Box 8784 STN T CSC
Ottawa, Ontario K1G 5J3
时光在路上 最后编辑于:2022年6月16日