Citizenship and

Immigration Canada
Citoyennet et
Immigration Canada
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IMM 0008 (10-2002) E
SCHEDULE 5
PROTECTED WHEN COMPLETED - B
SCHEDULE 5
DECLARATION OF INTENT TO RESIDE IN QUEBEC
ECONOMIC CLASSES
(DISPONIBLE EN FRANAIS - IMM 0008 F ANNEXE 5)
This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants.
The principal applicant must complete this form.













Declaration

I declare that my family members and I intend to live in the Province of Quebec.

I authorize the Government of Canada to share all necessary information with respect to my application for permanent residence in Canada, including the
decision made on my application, with officials of the Province of Quebec.
1. Your full name
Family name
Given name(s)
Given name(s)
2. Your date of birth Date (YYYY-MM-DD)
Signature
Date
(YYYY-MM-DD)
The principal applicant must complete this form.













Declaration

I declare that my family members and I intend to live in the Province of Quebec.

I authorize the Government of Canada to share all necessary information with respect to my application for permanent residence in Canada, including the
decision made on my application, with officials of the Province of Quebec.
1. Your full name
Family name
Given name(s)
Given name(s)
2. Your date of birth Date (YYYY-MM-DD)
Signature
Date
(YYYY-MM-DD)