Refugee protection: related forms

In support of transparency efforts, this section contains policy, procedures and guidance used by CIC staff as a courtesy to stakeholders.

In-Canada claims
Form number Title Purpose
IMM 1442B Full Document Entry – Generic (FOSS) IMM1442B: A generic form used for all secure documents (Refugee Protection Claimant Document, Interim Federal Health Certificate, visitor record, work or study permits, temporary resident permit).
IMM 5292B Full Document Entry – Generic (FOSS) IMM5292B: A generic form for non-secure documents (A44 report, eligibility decisions in respect of ineligible claims where the claimant is not eligible for a PRRA)
N/A (IRB form) Basis of Claim document Immigration and Refugee Board form completed by the claimant when making their refugee claim.
IMM 1392B Declaration Signed statement given by person concerned declaring information given is the truth (used when officer decides it is necessary).
IMM 1017 Medical Report – Section A Client Identification and Summary Used for the immigration medical examination (for claimant to take to a Panel Physician).
IMM 1262 Acknowledgement of Conditions Acknowledgement of the conditions imposed on the claimant.
IMM 1265 Interpreter Declaration Interpreters declaration of accurate interpretation.
BSF 536 Entry for Further Examination or Admissibility Hearing To allow the entry to Canada of a foreign national awaiting further examination.
IMM 5265B Notice of Seizure To notify a person that their possessions have been seized pursuant to R253 (1) (b).
BSF 667 Search To record search details including the type of search, authorization, officers involved and search results (used by CBSA officers only).
IMM 2048B Personal Service Contract (Interpreters) Personal service contract between CIC or CBSA and an interpreter.
IMM 5243B Referral to Refugee Protection Division To transmit information manually to the IRB when FOSS is unavailable
BSF 529 Notification to the Person Concerned by an Immigration Officer Used in cases of re-determination of eligibility, when FOSS is unavailable.
IMM 5476 Use of a Representative/Release of Information Used when the claimant is assisted by an authorized immigration representative.
IMM 0421B Withdrawal of a Claim for Refugee Protection prior to Referral to RPD Used when a claimant withdraws their claim before it has been referred to the IRB.
BSF 528 Notification to RPD, RAD and Person Concerned - Suspension To provide notification that eligibility consideration has been suspended.
IMM 5021B Voluntary Departure – Confirmation Confirmation by port of departure of voluntary departure from Canada. Copy for file.
IMM 0421B Order for Detention Used when detaining a person under the IRPA.
BSF 524 (formerly IMM 5245B) Request for Admissibility Hearing / Detention Review pursuant to the Immigration Division Rules When an admissibility hearing is scheduled, or when a detention review is required.
BSF 525 Notice of Admissibility Hearing Indicates the place, date, and time of an admissibility hearing.
IMM 5569 Notification of the Return of a Non-Resident Alien Under the Terms of the Agreement Between Canada and the United States for Cooperation in the Examination of Refugee Status Claims by Nationals of Third Countries To notify the U.S.A. Department of Homeland Security when a person will be returned to the United States under the Safe Third Country Agreement.
BSF 502 Notice to Transporter To notify a transportation company that an improperly documented person came to Canada on that carrier.
Reviews and interventions
Form number Title Purpose
IMM 5354 Request for Consideration of Minister's Intervention For use by officers when in possession of information that may support a possible intervention, cessation or vacation process.
PRRA
Form number Title Purpose
IMM 5503E Applying for a Pre-removal Risk Assessment: Unsuccessful Refugee Protection Claimants Individuals who were: unsuccessful in a refugee claim; ineligible to make a refugee claim; or unsuccessful in a prior PRRA and who are now facing removal, may apply for protection using this application.
IMM 5508E Application for a Pre-removal Risk Assessment Generic form used to gather information for making a risk assessment for individuals who are facing removal and who wish to apply for protection under PRRA.
IMM 5523E Applying for a Pre-removal Risk Assessment: Applicants described in Section 112 (3) To give individuals who are described in Section 112 (3) of the Immigration and Refugee Protection Act, and who are now facing removal, the opportunity to apply for protection.
IMM 5535E Application for a Risk Assessment further to Section 115(1) of the Immigration and Refugee Protection Act. Individuals who: are not entitled to apply for a Pre-Removal Risk Assessment; and are described in Section 115(1) of the Immigration and Refugee Protection Act and who are now facing removal, may apply for protection using this application.
Resettlement
Form number Title Purpose
Forms for use outside Canada:
Form number Form title Purpose
IMM 0008 Generic Application Form for Canada Application form for permanent residence in Canada.
IMM 0008E, schedule 2 Application for Permanent Residence in Canada - Schedule 2 Refugees Outside Canada To apply for resettlement to Canada as a Convention refugee or a member of the country of asylum class.
IMM 5669E Schedule A- Background/Declaration To provide background information.
IMM 0500E Immigration Loan/Contribution To authorize transportation loans, right of permanent residence loan and loan for medical examination and related costs.
IMM 0501B Immigration Loan and Undertaking to Repay Application for immigration loan and undertaking to repay the loan.
IMM 5292B Generic Document - 3 Part Distribution A generic form used for:
  1. the printing of the Confirmation of Permanent Residence document; and
  2. the printing of other non-secure documents
IMM 5544B Resettlement Needs Assessment Form To document information on the medical condition of refugees to help resettlement workers and private sponsors make appropriate reception and settlement arrangements
IMM 5485B Single Journey Travel Document for Resettlement to Canada For use when no other travel document is available
IMM 5413 Refugee sponsorship application Contains forms and information necessary for Sponsorship Agreement Holders (SAH), Constituent Groups (CG), Groups of Five (G5) and Community Sponsors (CS) to sponsor a refugee outside Canada
IMM 5373E Undertaking / Application to Sponsor Undertaking to sponsor Convention Refugees Abroad and Humanitarian-Protected Persons Abroad Part of IMM 5413 application package
IMM 5440E Settlement Plan and Financial Assessment- Sponsorship Agreement Holders and Constituent Groups Part of IMM 5413 application package
IMM 5373AE Settlement Plan and Financial Assessment- Group of Five Part of IMM5413 application package
IMM 5373BE Financial Profile - Group of Five Part of IMM5413 application package
IMM 5515E Settlement Plan and Financial Assessment- Community Sponsors Part of IMM5413 application package
IMM 5729E Consent to Disclose and Collect Personal Information Part of IMM5413 application package
IMM 5493E Application for Refugee sponsorship: Joint Assistance sponsorship
IMM 1324E Undertaking/Application for a Joint Assistance Sponsorship To provide an undertaking to sponsor a refugee requiring special assistance and whose admissibility depends upon the additional support of a sponsor
IMM 5494E Settlement Plan-Joint Assistance Sponsorship Part of IMM5493E application package
IMM 5504 Request for a Joint Assistance Sponsorship Refugee Profile Part of IMM5493E application package
IMM 5571E Request for Processing Family Members under the One-Year Window (OYW) of Opportunity Provisions To determine eligibility of family members to be processed under OYW opportunity (Quebec uses its own form)
IMM 5578E Request to process following family members under the one-year window of opportunity provisions.
For more forms related to in-Canada processing of resettled refugees (including assistance programs available), visit the inland processing section.
Permanent residence

For forms related to processing permanent residence applications from protected persons and related immigration categories, see the permanent residents section.