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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.

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