Applying to Resume Canadian Citizenship and for Persons Who Lost Citizenship as Minors
This form is to resume Canadian citizenship and for persons who lost citizenship as minors. The form provided here is simply a sample of what the actual Form CIT 0301E looks like.
Citizenship and Immigration Canada
APPLICATION TO RESUME CANADIAN CITIZENSHIP Under Subsection 11(1) and for PERSONS WHO LOST CITIZENSHIP AS MINORS Under Subsection 11(1.1)
FOR OFFICIAL USE ONLY
Receipt no. _________________________
UCI no. _________________________
Claim _________________________
Date of loss ___ ___D ___ ___M ___ ___ ___ ___Y
Loss confirmed by: _________________________
Signature _________________________
Date ___ ___D ___ ___M ___ ___ ___ ___Y
Certificate no. _________________________
Before you start, read the instructions
Please PRINT in ink or TYPE
1 ____ I am applying for resumption of Canadian citizenship under Subsection 11(1)
____ I am applying for resumption of Canadian citizenship under Subsection 11(1.1) (lost as a minor under the 1947 Act)
2 I want service in ____ English OR ____ French (Please check one)
3 I have special needs ____ No ____ Yes
If yes, explain: _________________________
4 Have you applied to resume citizenship before? ____ No ____ Yes
Date ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
Have you ever had a certificate of Canadian citizenship? ____ No ____ Yes
If yes, give information that appears on the certificate.
Family name _________________________
Given name(s) _________________________
Certificate no. _________________________
Date ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
My certificate was/is: ____ previously returned ____ attached ____ stolen ____ lost ____ destroyed
Was the theft/loss reported to police? ____ No ____ Yes
Details _________________________
Note: It is illegal to have more than one valid certificate of citizenship or naturalization. If you have any certificate of citizenship or naturalization or any pink transmission copy of a certificate, you have to send it back.
5 A Name (If applying within Canada use name exactly as shown on immigration document. If applying from outside Canada, please see appendix A.)
Family name _________________________
Given name(s) _________________________
B Legal name change since the name provided in 5A ____ No ____ Yes
If yes, provide legal name change document.
To Family name _________________________
Given name(s) _________________________
C Other names used (example maiden name or name at birth)
Family name _________________________
Given name(s) _________________________
D Name you want on citizenship certificate (documentation required)
Family name _________________________
Given name(s) _________________________
6 A Birth details
Date ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
Place ________________________ City, town, etc.
Country ________________________
B Personal Information
Sex ____ Male OR ____ Female
Height ______ cm OR ____ ft ____ in
Colour of eyes _______________
C Marital status ____ Single ____ Married ____ Common-law ____ Widowed ____ Divorced ____ Separated
D I have lived at this address __________ year(s) and _________ month(s)
8 A Are you a citizen of any other countries? ____ No ____ Yes
If yes, please list the date(s), country (countries) and how you obtained this citizenship.
FROM ___ ___ D ___ ___ M ___ ___ ___ ___ Y
What country? ________________________
How did you obtain this citizenship? ________________________
FROM ___ ___ D ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ D ___ ___ M ___ ___ ___ ___ Y
What country? ________________________
How did you obtain this citizenship? ________________________
FROM ___ ___ D ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ D ___ ___ M ___ ___ ___ ___ Y
What country? ________________________
How did you obtain this citizenship? ________________________
If you received a Canadian citizenship certificate before February 15, 1977 OR you have never had a Canadian citizenship certificate please list absences from Canada for 1 year or longer before 1977.
FROM ___ ___ D ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ D ___ ___ M ___ ___ ___ ___ Y
DESTINATION What country did you go to? ________________________
REASON Why did you go to this country? ________________________
FROM ___ ___ D ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ D ___ ___ M ___ ___ ___ ___ Y
DESTINATION What country did you go to? ________________________
REASON Why did you go to this country? ________________________
FROM ___ ___ D ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ D ___ ___ M ___ ___ ___ ___ Y
DESTINATION What country did you go to? ________________________
REASON Why did you go to this country? ________________________
C Are you a permanent resident of Canada? ____ Yes ____ No
If yes, indicate the date you became a permanent resident.
___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
If you are applying using subsection 11(1.1), sections 8D, 8E, 8F and 8G do not apply to you. Go to section 9.
D When did you return to Canada if different from 8C?
___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
E Did you obtain permanent residence in another country since becoming a permanent resident of Canada? ____ No ____ Yes
If yes, please list the country (countries) ________________________
F Have you left Canada in the last year? ____ No ____ Yes
If yes, please list all of your trips outside Canada (including vacations and all trips to the United States) in the last year.
FROM ___ ___ D ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ D ___ ___ M ___ ___ ___ ___ Y
DESTINATION ________________________
REASON FOR ABSENCE ________________________
FROM ___ ___ D ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ D ___ ___ M ___ ___ ___ ___ Y
DESTINATION ________________________
REASON FOR ABSENCE ________________________
FROM ___ ___ D ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ D ___ ___ M ___ ___ ___ ___ Y
DESTINATION ________________________
REASON FOR ABSENCE ________________________
G List all of your addresses (including foreign addresses) in the last year.
FROM ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ M ___ ___ ___ ___ Y
ADDRESS ________________________
CITY, PROVINCE, COUNTRY ________________________
FROM ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ M ___ ___ ___ ___ Y
ADDRESS ________________________
CITY, PROVINCE, COUNTRY ________________________
FROM ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ M ___ ___ ___ ___ Y
ADDRESS ________________________
CITY, PROVINCE, COUNTRY ________________________
9 PROHIBITIONS UNDER THE CITIZENSHIP ACT
1. Are you now or have you ever been in the last year:
• an inmate of a penitentiary, jail, reformatory, or prison?
• on probation?
• on parole?
2. In the past 3 years, have you been convicted of an indictable offence (crime) in Canada or an offence under the Citizenship Act?
3. Are you now charged with an offence (crime) or an offence under the Citizenship Act?
4. Are you now, or have you ever been, under a removal order (have you been asked by Immigration officials to leave Canada)?
5. Are you now under investigation for, or charged with, a war crime or a crime against humanity or have you ever been convicted of a war crime or a crime against humanity?
6. In the past 5 years, have you had Canadian citizenship which has been taken away (revoked)?
I have read and understand the prohibitions under the Citizenship Act. I declare that these prohibitions:
____ Do not apply to me. ____ Do apply to me. Provide details: _______________________
10 A Were you born outside Canada to a Canadian parent? ____ No ____ Yes
B Were you a British subject living in Canada before 1947? ____ No ____ Yes
If yes, on what date did you enter Canada to live?
___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
11 APPLICANT'S PARENTS
Answer all of the following questions:
Relationship to you
____ Natural father ____ Adoptive father
____ Natural mother ____ Adoptive mother
FATHER
Family name ________________________
Given name(s) ________________________
Country and date of birth ________________________, ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
Married in what country? ________________________
Date of marriage ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
Additional Information
How did he obtain Canadian citizenship? ________________________
Did he leave Canada for more than 1 year before 1977? ____ No ____ Yes
FROM ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ M ___ ___ ___ ___ Y
Destination (Country) ________________________
FROM ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ M ___ ___ ___ ___ Y
Destination (Country) ________________________
FROM ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ M ___ ___ ___ ___ Y
Destination (Country) ________________________
Is he or was he a citizen of a country other than Canada? ____ No ____ Yes
Give details (country, date and how citizenship was obtained) ________________________
Was he employed in Canada by a foreign government or international agency?
____ No ____ Yes
Give details ________________________
If father was born in Canada, was one of his parents employed by a foreign government or international agency?
____ No ____ Yes
Give details ________________________
MOTHER
Family name ________________________
Given name(s) ________________________
Country and date of birth ________________________, ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
Married in what country? ________________________
Date of marriage ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
Additional Information
How did she obtain Canadian citizenship? ________________________
Did she leave Canada for more than 1 year before 1977? ____ No ____ Yes
FROM ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ M ___ ___ ___ ___ Y
Destination (Country) ________________________
FROM ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ M ___ ___ ___ ___ Y
Destination (Country) ________________________
FROM ___ ___ M ___ ___ ___ ___ Y
TO ___ ___ M ___ ___ ___ ___ Y
Destination (Country) ________________________
Is she or was she a citizen of a country other than Canada? ____ No ____ Yes
Give details (country, date and how citizenship was obtained) ________________________
Was she employed in Canada by a foreign government or international agency?
____ No ____ Yes
Give details ________________________
If mother was born in Canada, was one of her parents employed by a foreign government or international agency?
____ No ____ Yes
Give details ________________________
12 If you are applying using subsection 11(1.1), section 12 does not apply to you. Go to section 13.
If you are a woman and married before January 1, 1947, answer the following questions.
If you married for the first time on or after January 1, 1947, this question does not apply to you. Go to Section 13.
Information on your husband (Provide details of every marriage before 1947.)
Husband's family name ________________________
Given name(s) ________________________
Husband's country of birth ________________________
Date of birth ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
Country of marriage ________________________
Date of marriage ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
Is your husband a Canadian citizen? ____ No ____ Yes
____ by birth OR ____ other ________________________
Number on husband's citizenship certificate (if applicable) ________________________
Date ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
CONSENT TO DISCLOSE PERSONAL INFORMATION
If you are not a resident of Canada, section 13 does not apply to you. Go to section 14.
CONGRATULATORY LETTER:
Request for authorization
Federal Members of Parliament (M.P.s) send a letter of congratulations to new citizens in their ridings. Do you authorize Citizenship and Immigration Canada to forward your name, address and preferred official language to your Member of Parliament?
____ Yes ____ No
This information will be disclosed once your Canadian citizenship is resumed.
14 CONSENT TO DISCLOSE PERSONAL INFORMATION
A NATIONAL REGISTER OF ELECTORS:
Request for authorization
Canadian citizens who are 18 years of age or older have the right to vote in federal elections and referendums.
Elections Canada needs your authorization to add your name to the National Register of Electors to ensure that you are included on the list of electors for federal elections and referendums.
Do you authorize Citizenship and Immigration Canada to forward your name, address, gender and date of birth to Elections Canada so that this information can be added to the National Register of Electors?
____ Yes ____ No
No information will be forwarded to Elections Canada until you resume Canadian citizenship. By law this information will be used for electoral purposes only.
For more information, please refer to Section 14 of "How to Complete Your Application".
B QUÉBEC'S PERMANENT LIST OF ELECTORS:
Request for authorization
To make sure that you are on the list of electors for provincial, municipal or school elections, the Chief Electoral Officer of Québec needs to add your name to Québec's Permanent list of electors.
Do you authorize Citizenship and Immigration Canada to forward your name, address, gender and date of birth to the Chief Electoral Officer of Québec so that this information can be added to the permanent list?
____ Yes ____ No
No information will be forwarded until you resume Canadian citizenship. By law this information will be used for electoral purposes only.
For more information, please refer to Section 14 of "How to Complete Your Application.
15 SIGNATURE OF APPLICANT
I agree to advise Citizenship and Immigration Canada if any information on this form changes before the processing of my application is complete. I understand the contents of this form. I declare that the information provided is true, correct, and complete, and that the photographs enclosed are a true likeness of me. I understand that if I make a false declaration, or fail to disclose all information material to my application, I could lose my Canadian citizenship and be charged under the Citizenship Act.
I have indicated in Section 9 whether the prohibitions apply to me.
Signature of APPLICANT _____________________________
Place _____________________________
Date ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
IMPORTANT NOTE: Remember to make sure that you are eligible to apply for citizenship on the day before you SIGN this application.
16 INDIVIDUAL, FIRM OR ORGANIZATION WHO ASSISTED IN THE COMPLETION OF THIS APPLICATION
(The applicant does not complete this section)
Name of individual who assisted in completing this application form: _____________________________
Name of firm, organization: _____________________________
Address: _____________________________
_____________________________
Signature of INDIVIDUAL _____________________________
Date ___ ___ Day ___ ___ Month ___ ___ ___ ___ Year
REMEMBER: If you are sending more than one application, send all of them together in one envelope. The applications will be processed together.
FAILURE TO INCLUDE THE NECESSARY DOCUMENTATION (e.g. 2 PIECES OF IDENTIFICATION) WILL RESULT IN DELAYS IN PROCESSING YOUR APPLICATION.
Protected Information
Personal Information Bank CIC PPU 050
The information you provided on this form is collected under the authority of the Citizenship Act and will be used to determine eligibility for the grant of Canadian citizenship according to the requirements of the Act, and to maintain a record of persons to whom citizenship certificates were issued. It will be retained in the Personal Information Bank CIC PPU 050. It may be shared with other organizations in accordance with the consistent use of information under the Privacy Act. Under the Privacy Act and the Access to Information Act individuals have the right to protection of and access to their personal information. Details on these matters are available at infosource.gc.ca and through the Citizenship and Immigration Canada Call Centre. Infosource is also available at Public Libraries in Canada.