Applying to change conditions or extend your stay in Canada — Worker (IMM 5553)

Completing the forms

The documentation you provide will be used to establish that your authorization to remain in Canada would not be contrary to the Act. You must provide truthful, accurate information. The information provided may be verified. Processing will stop immediately if you give false or misleading information. It is an offence under section 127 of the Immigration and Refugee Protection Act to knowingly make a false statement on this form.

Application to change conditions, extend my stay, or remain in Canada (IMM 1249)

As most of the form is self-explanatory we have only provided supplementary instructions where required. If you need more space, attach a separate sheet of paper and indicate the letter and/or number of the question you are answering. Your application may be returned or refused if it is not properly completed, or if all of the necessary documents have not been submitted. Type or print clearly in black or blue ink. If you know your client ID number, print it in the space provided.

Each member of your immediate family (spouse or common-law partner, dependent children) who wishes to remain longer, study or work in Canada must apply for permission to do so. If you all apply at the same time for an extension, each person will not have to a submit separate application form. Instead, fill in one form including your details and those of your immediate family. All appropriate documentation and the required fee for each person must also be included.

“I am applying for”:

If you require only one service, tick the box that corresponds to the service you are requesting. For example, tick box “C” if you are applying for a renewal of your work permit. If you require more than one service and you are using only one application, tick the boxes that correspond to each of the services you require. For example: if you are applying for a renewal of your work permit and for a new study permit, tick boxes “C” and “B” and include the required documentation and fees.

A – Personal information

Surname (family name) and given name(s)

Print all names as they appear on your passport or identity document. Do not use initials.

Other names

Print all names you have ever used, including different spellings of your name. Explain what these names are, e.g., ‘Maggie’ (nickname), ‘Smith’ (birth name/maiden name), ‘Leroux’ (former married name).

Citizenship

If you are a citizen of more than one country, enter the names of all countries.

Passport number

If you did not use a passport to enter Canada, indicate the type and number of other travel or identity documents you used to enter Canada. Passports and travel documents must be valid for the duration of your stay.

Country of last permanent residence

Regardless of the time you may have resided in a country, if your status was of a temporary nature (foreign student, guest worker, etc.) it is not your country of last permanent residence. If your country of last permanent residence is the country where you were born, put an “x” in the box “since birth”. Otherwise put an “x” in “since” and print the year that you moved to that country.

Languages

Write your native language (the language you learned at home in childhood and still understand).

Check the box to indicate which of Canada’s official languages (French or English) you use most frequently. If you do not use French or English, check the “Neither” box.

Note: This question is not used for selection purposes.

Addresses

Provide your current mailing address in Canada. All correspondence will be sent to this address.

Note: If you wish to authorize a Canadian representative to receive correspondence concerning your application, indicate their address in this box and on the form Use of a Representative (IMM 5476).

Telephone number for messages

If you have access to a telephone where a message can be left for you, print the number here.

B – My family members

You must give information about your family members. Family members are your spouse or common-law partner, your own dependent children or those of your spouse or common-law partner and the dependent children of dependent children. A common-law partner is a person of the opposite or same sex who is currently cohabiting and has cohabited in a conjugal relationship with you for a period of at least one year.

Your family member will be considered your dependent child if that child:

A. is under the age of 22 and single, i.e. not married and not in a common-law relationship; or

B. married or entered into a common-law relationship before the age of 22 and, since becoming a spouse or a common-law partner, has:

• been continuously enrolled and in attendance as a full-time student in a post-secondary institution accredited by the relevant government authority and
• depended substantially on the financial support of a parent; or

is 22 years of age or older and, since before the age of 22, has

• been continuously enrolled and in attendance as a full-time student in a post-secondary institution accredited by the relevant government authority and
• depended substantially on the financial support of a parent; or

C. is 22 years of age or older, has depended substantially on the financial support of a parent since before the age of 22 and is unable to provide for him/herself due to a medical condition.

Children included in the application must meet the definition of “dependent children” both at the time the application is made and, without taking into account whether they have attained 22 years of age, at the time the visa is issued to them.

Include them on your application by providing their names and other information in the appropriate space on the application form. Indicate if your family members are currently in Canada.

Important: In order to benefit from provisions outlined in the Immigration and Refugee Protection Act and Regulations for spouses or common-law partners of workers or students, you must provide proof of your relationship and status in Canada. You must provide a marriage certificate and birth certificates for any accompanying family members. If you are in a common-law relationship and your common-law spouse will accompany you to Canada, you must complete the enclosed form, Statutory Declaration of Common-Law Union (IMM 5409) [PDF]. Also provide evidence outlined on the form to support your relationship.

For each family member print:

Surname (family name) and given name(s)

Print all names as they appear on the passport or identity document. Do not use initials.

Relationship

Print the person’s relationship to you - husband, wife, son or daughter.

Passport and expiry date

If it was not a passport which was used to enter Canada, indicate the type and number of other travel or identity documents used. Passports and travel documents must be valid.

Languages

Write your native language (the language you learned at home in childhood and still understand).

Check the box to indicate which of Canada’s official languages (French or English) you use most frequently. If you do not use French or English, check the “Neither” box.

Note: This question is not used for selection purposes.

C – Coming into Canada

This information will assist us in retrieving your previous records.

D – My request

Box 10

You must explain why you wish an extension and/or a change conditions for yourself or your family members.

If you are a temporary resident permit (TRP) holder you must inform us of any change to your personal circumstances. You must also inform us if any of the reasons you were originally issued a permit change after it is issued. For example, if you applied unsuccessfully for an immigrant visa to live with a family member (sponsor) in Canada, are you still living with your sponsor? Or, have you been convicted of a new offence since you first received your permit?

If your temporary resident status has expired and you wish consideration for restoration, explain the reasons for this.

Box 11

Provide details of how you will support yourself and your family members while in Canada and how you will pay for transportation to leave Canada.

Provide specifics on ‘Other’ sources of support (employment income/employer).

If a relative or friend will provide support include their name, address and the relationship to you.

E – Additional information

Box 12

If you or your family members remained beyond the validity of your status, attended school without permission or worked without permission, give full details and circumstances concerning the situation(s).

Box 13

Indicate if you or any of your family members in Canada have ever been convicted of, or charged with a crime or offence in any country. If convicted, indicate whether a pardon has been granted.

Box 14

Indicate if you or any of your family members have suffered from any serious mental or physical illness. If so, provide full details.

G – Declaration of applicant

You must sign and date the application. Failure to do so will result in it being returned to you.

We suggest that you retain photocopies of your application and supporting documentation for your records.

Use of a representative (IMM 5476)

Complete this form if you are appointing a representative.

If you have dependent children aged 18 years or older, they are required to complete their own copy of this form if a representative is also conducting business on their behalf.

A representative is someone who has your permission to conduct business on your behalf with Citizenship and Immigration Canada. When you appoint a representative, you also authorize CIC to share information from your case file to this person.

You are not obliged to hire a representative. We treat everyone equally, whether they use the services of a representative or not. If you choose to hire a representative, your application will not be given special attention nor can you expect faster processing or a more favourable outcome.

The representative you appoint is authorized to represent you only on matters related to the application you submit with this form. You can appoint only one representative for each application you submit.

There are two types of representatives:

Unpaid representatives

• friends and family members who do not charge a fee for their advice and services;
• organizations that do not charge a fee for providing immigration advice or assistance (such as a non-governmental or religious organization);
• consultants, lawyers and Québec notaries who do not, and will not, charge a fee to represent you.

Paid representatives

If you want us to conduct business with a representative who is, or will be charging a fee to represent you, he or she must be authorized. Authorized representatives are:

• immigration consultants who are members in good standing of the Canadian Society of Immigration Consultants (CSIC);
• lawyers who are members in good standing of a Canadian provincial or territorial law society and students-at-law under their supervision;
• notaries who are members in good standing of the Chambre des notaires du Québec and students-at-law under their supervision.

If you appoint a paid representative who is not a member of one of these designated bodies, your application will be returned. For more information on using a representative, visit our website.

Section B.

5. Your representative’s full name

If your representative is a member of CSIC, a law society or the Chambre des notaires du Québec, print his or her name as it appears on the organization’s membership list.

8. Your representative’s declaration

Your representative must sign to accept responsibility for conducting business on your behalf.

Section D.

10. Your declaration

By signing, you authorize us to complete your request for yourself and your dependent children under 18 years of age. If your spouse or common-law partner is included in this request, he or she must sign in the box provided.

Release of information to other individuals

To authorize CIC to release information from your case file to someone other than a representative, you will need to complete the form Authority to Release Personal Information to a Designated Individual (IMM 5475) which is available on our website and from Canadian embassies, high commissions and consulates abroad.

The person you designate will be able to obtain information on your case file, such as the status of your application. However, he or she will not be able to conduct business on your behalf with CIC.

You must notify us if your representative’s contact information changes or if you cancel the appointment of a representative.

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