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CLIENT SIGNATURE (must sign inside the white box in black ink only) DU CLIENT (doit signer it l'interieur de la boite blanche it I'encre noire seulement)

THIS FORM HAS BEEN ESTABLISHED THIS DOCUMENT IS THE PROPERTY

BY THE MINISTER

OF CITIZENSHIP OF CANADA

AND IMMIGRATION

FORMULAIRE LE PRESENT

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PAR LE MINISTRE

DE LA CITOYENNETE

ET DE L'IMMIGRATION DU CANADA

OF THE GOVERNMENT

DOCUMENT

EST LA PROPRIETE

DU GOUVERNEMENT

IMM 5292 (CON) B (06-2004) GENERIC - GENERIQUE

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THIS FORM HAS BEEN ESTABLISHED THIS DOCUMENT IS THE PROPERTY BY THE MINISTER OF CITIZENSHIP OF CANADA AND IMMIGRATION FORMULAIRE LE PRESENT ETABLI PAR LE MINISTRE DE LA CITOYENNETE ET DE L'IMMIGRATION DU CANADA

OF THE GOVERNMENT

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IMM 5292 (CON) B (06-2004) GENERIC - GENERIQUE

PART PARTIE -

Canada

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Citoyermete et Immigration Canada


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THIS FORM HAS BEEN ESTABLISHED THIS DOCUMENT IS THE PROPERTY BY THE MINISTER OF CITIZENSHIP OF CANADA AND IMMIGRATION FORMULAIRE LE PRESENT ETABLI PAR LE MINISTRE DE LA CITOYENNETE ET DE L'IMMIGRATION DU CANADA

OF THE GOVERNMENT

DOCUMENT

EST LA PROPRIETE

DU GOUVERNEMENT

IMM 5292 (CON) B (06-2004) GENERIC - GENERIQUE

PART PARTIE -

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Citizenship and Immigration Canada

Citoyennete Immigration

et Canada

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THIS FORM HAS BEEN ESTABLISHED THIS DOCUMENT IS THE PROPERTY

BY THE MINISTER

OF CITIZENSHIP OF CANADA

AND IMMIGRATION

FORMULAIRE LE PRESENT

ETABLI

PAR LE MINISTRE

DE LA CITOYENNETE

ET DE L'IMMIGRATION DU CANADA

OF THE GOVERNMENT

DOCUMENT

EST LA PROPRIETE

DU GOUVERNEMENT

IMM 5292 (CON) B (06-2004) GENERIC - GENERIQUE

PART PARTIE -

Canada

,--------------------~---------------,----------------------------------

.+.

Citizenship and Immigration Canada

Citoyennete et Immigration Canada

PROTECTI;D WHEN COMPLETED PROTEGE UNE FOIS REMPLI use only - Reserve

,-------------------,
Headquarters

a I'administration

centrale

Bar code use only - Reserve au code-barre

PAGE~

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P,I ACCORDANCE WITl-l ;UeSECTWN 44{U


ACT" 1. HE:.BEBi HE:POPT 'rH{n~ JENNI FEH ANN

OF THE H'!l"lrGt~:;4T!O!\i ANI:IF'd~FlJf3EE PFt.OfEGTWN

I S A PEF:t;OI\! WHO 1S 3

THAT IS

,.JENNIFE~

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t:D~LE'( CrnZEN OR P[RH~,NENT RES. 1DENT (IF' C{'tHADA.

NOT P, CANADIAN

H1 SEEk I NO ENrWf

AS AN H'WII lJRt;j'.lT TO CAN:Ai]A. AS REl1ut REI),

1S I\If(l' I N POSSESSION OF Ii W~L i!) H'lfW3R.~NT V!SA

THIS FORM HAS BEEN ESTABLISHED FORMULAIRE ETABLI

BY THE MINISTER

OF CITIZENSHIP

AND IMMIGRATION

- THIS DOCUMENT DOCUMENT

IS THE PROPERTY EST LA PROPRIETE

OF THE GOVERNMENT DU GOUVERNEMENT

OF CANADA DU CANADA

PAR LE MINISTRE

DE LA CITOYENNETE

ET DE L'IMMIGRATION

- LE PRESENT

IMM 5292 (CON) B (06-2004) GENERIC - GENERIQUE

PART PARTIE

Canada

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.+.

---

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----------------------------

--

--_

Citizenship and Immigration Canada

Citoyennete Immigration

et Canada

PROTECTEP WHEN COMPLETED PROTEGE UNE FOIS REMPLI use only - Reserve

r-------------------------------------------~
Headquarters

a I'administration

centrale

Bar code use only - Reserve au code-barre

PAGE:

2.

DOCUMENT NO: N9114)~744

fjf-TICH

THIS FORM HAS BEEN ESTABLISHED FORMULAIRE ETABLI

BY THE MINISTER

OF CITIZENSHIP

AND IMMIGRATION

- THIS DOCUMENT DOCUMENT

IS THE PROPERTY EST LA PROPRIETE

OF THE GOVERNMENT DU GOUVERNEMENT

OF CANADA DU CANADA

PAR LE MINISTRE

DE LA CITOYENNETE

ET DE L'IMMIGRATION

- LE PRESENT

IMM 5292 (CON) B (06-2004) GENERIC - GENERIQUE

PART PARTIE -

Canada