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RELATIONSHIP INFORMATION AND SPONSORSHIP EVALUATION

If you need more space for any of the questions, use another sheet and write the part and question number.
PERSONAL INFORMATION ABOUT SPONSOR
Family name Given name(s) Date of birth (YYYY-MM-DD) Client ID (if you know it)

PERSONAL INFORMATION ABOUT SPOUSE OR PARTNER BEING SPONSORED (PRINCIPAL APPLICANT)

Family name Given name(s) Date of birth (YYYY-MM-DD) Client ID (if you know it)

PART A - SPONSORSHIP EVALUATION AND INFORMATION ABOUT THE SPONSOR - TO BE FILLED OUT BY SPONSOR
1. Sponsor's employment history

Starting with your current employer, if applicable, give details of all employers you have worked for over the past five years. Make sure there are no gaps.
If you were unemployed, explain how you supported yourself.
If you were self-employed, write the name of your business and the date it was established.
Use the gross amount (before taxes) for your monthly salary or income.

Dates Employer Monthly gross

Occupation/Position
From (YYYY-MM) To (YYYY-MM) Give name, complete address and telephone number for each employer salary/income

2. Other sponsorships

Have you sponsored in the past, or are you currently sponsoring, any other members of your family in a different application?

No Go to question 3.

Yes Give details in the table below.

List all people included in past undertakings (sponsorships) you signed as a sponsor or co-signer (includes people who are not permanent residents yet).

Date of birth Indicate if

Family name Given name(s)
(YYYY-MM-DD) sponsor or co-signer

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3. Other financially dependent people

Give details of any other person who is financially dependent on you (whether they are living with you or not) and who is not already listed in the tables
above. Include previous spouses or partners and any children from past relationships.
Date of birth
Family name Given name(s)
(YYYY-MM-DD)

4. Level of education

What is the highest level of education you have completed?

Elementary/Primary school Number of years completed College/University Number of years completed

Secondary/High school Number of years completed Post-graduate studies Number of years completed

5. Address history

List all addresses where you have lived in the past five years. Do not use P.O. box addresses.

Dates Province, Postal code/

Street and number City or town Country
From (YYYY-MM) To (YYYY-MM) State or District Zip code

6. Residence in Canada

Do you live in Canada now?

Yes Go to question 7.

When did you last live in Canada?

No

When do you plan to return to Canada to resume residence?

Where do you plan to live when you return to Canada?

7. Consent to disclose

If there is an investigation into marriage fraud about you, do you consent to Immigration, Refugees and Citizenship Canada and the Canada Border
Services Agency releasing the results to your spouse or partner?

Yes No

My consent will stay valid until I revoke consent in writing to Immigration, Refugees and Citizenship Canada.

8. Declaration of sponsor

I declare that the information I have given is truthful, complete and correct.

Sponsor's signature Date (YYYY-MM-DD)

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PART B - INFORMATION ABOUT THE PRINCIPAL APPLICANT - TO BE FILLED OUT BY THE PRINCIPAL APPLICANT
1. Before this relationship, was your sponsor related to you in any way? e.g.
Your sponsor was related to a member of your family.
Your sponsor's family member was related to you or a member of your family.

Yes No

If yes, give their names and relationship to you or your sponsor, as applicable (including previous in-laws or spouse, etc.).

Date of birth
Family name Given name(s) Relationship
(YYYY-MM-DD)

2. Do you have any relatives (including aunts, uncles, cousins, etc.) living in Canada? If yes, give their full name(s), address(es) and relationship to you. You
do not have to list family members listed on the Additional Family Information form (IMM 5406).
Date of birth Marital
Family name Given name(s) Place of birth Relationship Current address
(YYYY-MM-DD) Status

3. Consent to disclose

If there is an investigation into marriage fraud about you, do you consent to Immigration, Refugees and Citizenship Canada and the Canada Border
Services Agency releasing the results to your spouse or partner?

Yes No

My consent will stay valid until I revoke consent in writing to Immigration, Refugees and Citizenship Canada.

4. Declaration of applicant

I declare that the information I have given is truthful, complete and correct.

Principal applicant's signature Date (YYYY-MM-DD)

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PART C - INFORMATION ABOUT RELATIONSHIP - TO BE FILLED OUT BY THE SPONSOR AND THE PRINCIPAL APPLICANT
1. When was the first time you met in person?
Date (YYYY-MM-DD) Where

Describe the circumstances of your first meeting

If yes, who introduced you?

Did anyone introduce you? No Yes

2. Did you have any contact before you met in person? Yes No

If yes, give details (e.g. who initiated the first contact, date of first contact, was it by phone, letter, e-mail, social media, etc.)

3. Are you living together now? Yes No

If yes, how long have you been cohabiting (living together)? Give the period(s) you have been living together after your conjugal* relationship started.
* Conjugal relationship means a committed and mutually interdependent relationship of some permanence where a couple has combined their affairs to the
extent possible (marriage-like).

If no, explain why not. If either of you are living with someone else, include their name and their relationship in the explanation.

4. If you are not living together, have you visited each other during your relationship? Yes No

If no, explain why not.

If yes, give details below.

Dates Who travelled to visit whom? Did you stay together at the same location? Where did you stay?
From (YYYY-MM) To (YYYY-MM)

Yes No

Yes No

Yes No

Yes No

Yes No

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5. What language(s) do you use when communicating with each other?

6. How often do you communicate when you are not together and how?

7. Do your close friends, family and children know about your relationship? Yes No

If no, explain why not.

If yes, give details below.

Are they related to Date they met sponsor
Relationship to sponsor
Family name Given name(s) sponsor or principal or principal applicant
or principal applicant
applicant (YYYY-MM-DD)

8. If you are married, answer a) below. If not go to question 9.

a) Was your marriage arranged? Yes No

If yes, describe how the marriage was arranged (by whom, when, where).

9. Were there formal ceremonies or events to recognize or celebrate your relationship, e.g., engagement ceremony, traditional or customary marriage
ceremony, commitment ceremony, partnership ceremony, reception, honeymoon, etc.?

Yes No

If no, explain why not.

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If yes, give details below.

Date Who performed the

Description of ceremony or event Location Number of guests
(YYYY-MM-DD) ceremony, if applicable

Did any of the following people go to any of the events above?

a) Principal applicant's parent(s)? Yes No

b) Principal applicant's child(ren) if applicable? Yes No

c) Principal applicant's other family members or relatives? Yes No

d) Sponsor's parent(s)? Yes No

e) Sponsor's child(ren) if applicable? Yes No

f) Sponsor's other family members or relatives? Yes No

If no to any of the above, explain.

10. Are either of you pregnant?

Yes No If yes, what is the due date (YYYY-MM-DD)?

11. Is there more information you wish to share to support your relationship?

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12. Declaration of sponsor

I declare that the information I have given is truthful, complete and correct.

Sponsor's signature Date (YYYY-MM-DD)

13. Declaration of applicant

I declare that the information I have given is truthful, complete and correct.

Principal applicant's signature Date (YYYY-MM-DD)

14. Interpreter Declaration

This section must be fully completed if an interpreter assisted you in the preparation of this form.

I, , solemnly declare that I have faithfully and accurately interpreted in the

language the content of this application and any related forms to the persons concerned.

I have been informed by the persons concerned, and I do verily believe, that they completely understand the nature and effect of these forms, and I make
this solemn declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath.

Interpreter's
signature Date (YYYY-MM-DD)

Disclosure

Information provided to Immigration, Refugees and Citizenship Canada (IRCC) is collected under the authority of the Immigration and Refugee Protection Act (IRPA) to determine
admissibility to Canada. Information provided may be shared with other Canadian government institutions such as, but not limited to, the Canada Border Services Agency (CBSA),
the Royal Canadian Mounted Police (RCMP), the Canadian Security Intelligence Service (CSIS), Global Affairs Canada (GAC), Employment and Social Development Canada
(ESDC), Canada Revenue Agency (CRA), provincial and territorial governments and foreign governments in accordance with subsection 8(2) of the Privacy Act. Information may
be disclosed to foreign governments, law enforcement bodies and detaining authorities with respect to the administration and enforcement of immigration legislation where such
sharing of information may not put the individual and or his/her family at risk. Information may also be systematically validated by other Canadian government institutions for the
purposes of validating status and identity to administer their programs.

Depending on the type of application made, the information you provided will be stored in one or more Personal Information Banks (PIB) pursuant to section 10(1) of Canada's
Privacy Act. Individuals also have a right to protection and access to their personal information stored in each corresponding PIB under the Access to Information Act. Further
details on the PIBs pertaining to IRCC's line of business and service and the Government of Canada's access to information and privacy programs are available at the Infosource
website (http://infosource.gc.ca) and through the IRCC Call Centre. Infosource is also available at public libraries across Canada.

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