Use of a Representative Form (IMM 5476)

This video will help explain each question on the Use of a Representative form (IMM 5476). Once you are ready to start your form, you can follow along with the video. Listen to each explanation and then press pause as you answer your question on the form. Once you’re ready, press play to move to the next question.

The best way to make sure you have completed all the steps is to read the Instruction Guide.

Use of a Representative Form (IMM 5476)

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Transcript: “Use of a Representative Form (IMM 5476)”

Video length: 7:04 minutes

The video opens with a still image of a woman in a business suit standing in front of an animation of the map of Canada. At the top of the screen, the title of the video appears, with the subtitle “Video Guide” appearing below.

Narrator: Welcome! If you are using a representative to help you with a Citizenship and Immigration Canada (CIC) application, you need to complete the Use of a Representative form, also known as form IMM 5476.

The image fades away and a text box appears. The text “What is a representative?” appears near the top of the text box, followed by the text spoken by the narrator which is shown for emphasis.

Narrator: A representative is someone who conducts business with CIC for you and with your permission. They may be a family member, friend, citizenship, immigration consultant, lawyer, or other. The person you appoint may fill out your forms, submit your application or talk to CIC about your file.

Another text box appears which contains the following text spoken by the narrator for emphasis.

Narrator: You are not required to hire a representative.

This text remains on screen while the narrator continues.

Narrator: The Government of Canada treats all applicants equally, whether they have a representative or not. 

The text box disappears and an image of the CIC website appears. It shows an instruction guide available on the website.

Narrator: CIC’s forms have instruction guides to help you complete your applications. The guides provide step-by-step instructions. They tell you how to answer each question and they provide clear information about the documents you must submit to us.

A new text box appears which contains the following text spoken by the narrator for emphasis.

Narrator: If you hire a representative, we will not give your application special attention or process it faster. It will not affect the final decision made about your application.

Another text box appears which contains the following text spoken by the narrator for emphasis.

Narrator: You can appoint only one representative for each application you submit.

Another text box appears which contains the following text spoken by the narrator for emphasis.

Narrator: You can choose to appoint or to cancel a representative at a later date, after your application has been submitted.

This text remains on screen while the narrator continues.

Narrator: To do so, you must send us a completed IMM 5476 form to tell us that you have changed representatives or that you no longer wish to use one.

The text box disappears and a copy of the “Use of a Representative” form appears on the screen.

Narrator: Let’s take a closer look at how to complete the Use of a Representative form. Answer each question by typing your information into the white spaces. A check mark will appear in the boxes as you click on them. You can save the form to your computer.

A mouse icon clicks on a blank field on the form and the words “Family Name” are typed into the space. The mouse icon then clicks on a box and a check mark appears. An image of a laptop appears on top of the form.

Narrator: Ready? Follow along with the video as you complete the form. You may press Pause and Play as you answer each question.

An image of a video player is shown, with the mouse icon clicking on the “Pause” and “Play” buttons.

Narrator: And don’t forget! The Video Centre on our website has other useful tutorials to help you complete your application. Be sure to take a look.

The web address “cic.gc.ca/videocentre” appears below the image of the video player.  

Narrator: With form IMM 5476 in front of you, let’s get started!

The “Use of a Representative” form appears on screen. As each question is explained, it is highlighted on the form. 

Narrator: First, are you appointing a representative? If you are, check the top box and complete sections A, B and D of the form. If you are cancelling a representative, check the other box and complete sections A, C and D.

A text box appears which contains the following text spoken by the narrator for emphasis.

Narrator: You may appoint a representative and cancel the appointment of another on the same form. In this case, you must check both boxes here.

The text box disappears.

Narrator: In Section A, enter the following information:

1. Your family name and all of your given names;

2. Your date of birth;

3. If you have already submitted your application, the name of the office where you submitted the application, and the type of application. If you have not already submitted your application, complete this form and include it with your application;

4. Your Citizenship and Immigration Canada identification number, if you have one and if you know it.  You may know it as your Client ID, your immigration file number or your UCI number.

In Section B, you appoint your representative to work on your application.

A text box appears which contains the following text spoken by the narrator for emphasis.

Narrator: This person can only represent you for the application you list on your form.

The text box disappears.

Narrator: Carefully read the bullet statements in Section B. Make sure that they apply to you and that you understand them.

5. Enter your representative’s family name and all given names.

6. If your representative is unpaid or uncompensated, check the box that best describes who they are.

A text box appears which highlights the following text spoken by the narrator for emphasis.

Narrator: Unpaid representatives include friends, family and members of groups who are not paid to help you. A lawyer, consultant or Quebec notary can also be listed here as long as they do not charge a fee to represent you.

The text box disappears.

Narrator: If you have paid or will pay your representative, that person must be a member of one of the groups listed. Check the correct box and provide your representative’s membership ID number, and the province or territory.

A text box appears which contains the following text spoken by the narrator for emphasis.

Narrator: If you appoint a paid representative who is not a member of one of these organizations, we will return your application to you.

The text box disappears.

Narrator: 7. Enter your representative’s contact information: the name of the firm or organization, if applicable, mailing address, postal code or ZIP code, telephone number, fax number, and e-mail address. If you are appointing a student-at-law to represent you include their supervising lawyer’s information including their membership ID.

By entering an e-mail address, you authorize CIC to send any file updates and personal information related to your application to this e-mail address.

A text box appears which contains the following text spoken by the narrator for emphasis.

Narrator: You must notify us if your representative’s contact information changes.

The text box disappears.

Narrator: 8. This is your representative’s declaration. Your representative must read the bullet statements carefully and confirm that they are true, then sign and date the form.

In Section C, you cancel the appointment of a representative. This means that you no longer wish to authorize your representative to receive information or to conduct business for you. If you are not cancelling a representative, move to Section D.

If you are cancelling a representative, read the withdrawal statement and make sure you understand it. Then list the representative’s full name and the name of his or her firm or organization.

Section D is the declaration section, where you sign to confirm that all of the information you entered is true, correct and complete. Read the statements carefully, then sign and date the form. If your spouse or common-law partner is included in this request, he or she must also sign and date the form.

Narrator: You have now completed the form. If you used a computer, you can save your file. You are now ready to print!

The form and images of a laptop and a printer appear on the screen.

Narrator: Be sure to sign and date your form. We cannot process it without your signature and the date.

The signature box on the form is highlighted in yellow. An image of a pen appears on top of the form. A text box then appears which contains the following text spoken by the narrator for emphasis.

Narrator: Remember: if you decide to cancel the appointment of your representative, you must complete a new IMM 5476 form. Be sure to send it to the office where you submitted your original application so we can keep your file updated.

The text box disappears.

If you have questions about this form, read the instruction guide, which is available at cic.gc.ca/repform

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