Fillable Form

Citizenship and Citoyenneté et PROTECTED WHEN COMPLETED - B

Immigration Canada Immigration Canada
PAGE 1 OF 2

IMM
SPONSORSHIP EVALUATION
(for persons who want to sponsor their spouse, common-law partner, conjugal partner or 5481
dependent children who have no dependent children of their own) (05-2003)
English

Sponsors living in Quebec need not complete this form. 1. Your full name

Family name
Do not complete this form if you are sponsoring:
• a spouse, common-law partner or conjugal partner who has
Given name(s)
dependent children who have dependent children of their own;
• a dependent child who has dependent children of his or her own.
1
Instead, you must fill in the Financial Evaluation form. This form is
accompanied by instructions. You can order a set through a Call
Centre or print it from our Web site at www.cic.gc.ca. The set
number is IMM 5482. FAMILY MEMBERS AND PERSONS FINANCIALLY DEPENDENT ON YOU

2. A) Current undertaking
Read the instructions on how to complete the forms before you start Number of persons included in boxes 1 to 4 of Section C on
to fill in this form. your Application to Sponsor and Undertaking (form IMM 1344A)
B) Previous undertakings
i) Number of persons included in previous undertakings you
signed as a sponsor and that are still in effect.
Provide details on the back of this page.
ii) Number of persons included in previous undertakings you
signed as a sponsor and that are not yet in effect (persons
who have not yet become permanent residents).
Provide details on the back of this page.

iii) Number of persons included in previous undertakings you

co-signed where these undertakings are still in effect.
Provide details on the back of this page.

iv) Number of persons included in previous undertakings you

co-signed where these undertakings are not yet in effect
(persons who have not yet become permanent residents).
Provide details on the back of this page.
3. Persons not included in 2. above
A) Your spouse or common-law partner. Provide details on the
back of this page.
B) Other members of your family dependent on you financially,
whether they are living with you or not. Enter their number in
the box on the right and provide details on the back of this
page.

4. Total number of persons in 1., 2. and 3. above

Add the number entered in the boxes on the right and write
the total here.

5. Are you currently employed?

No Yes Provide employer's details below.

Name

Address

Country code Area code Number

Phone
number ( ) ( )

Occupation/
Position

Day Month Year

Start date

Name of
supervisor

This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants.
(DISPONIBLE EN FRANÇAIS - IMM 5481 F)
 PAGE 2 OF 2
Details of family members and persons financially dependent on you
Date of birth
Family name Given name(s)
D M Y

2. B) i) Persons included in previous undertakings you signed as a sponsor and that are still in effect.

2. B) ii) Persons included in previous undertakings you signed as a sponsor and that are not yet in effect.

2. B) iii) Persons included in previous undertakings you co-signed and that are still in effect.

2. B) iv) Persons included in previous undertakings you co-signed and that are not yet in effect.

3. A) Your spouse or common-law partner if not listed in Section C of your Application to Sponsor and Undertaking (IMM 1344A) or in 2. B) above.

3. B) Other members of your family unit financially dependent on you, whether they are living with you or not, and not listed in Section C of your Application to
Sponsor and Undertaking (IMM 1344A) or in 2. B) above.

IMM 5481 (05-2003) E