Government of Canada Gouvernement du Canada PROTECTED WHEN COMPLETED -@ APPLICATION FOR VISITOR VISA (TEMPORARY RESIDENT VISA) Ifyou neec!more space for any section, prin ou an addtional page containing the appropriate section, complete and submititwith your application apa [a] Teanteevier [a] wasreaaeres =| Fam name (shown on your ero orael docu) Gon namet (shown on your patpert orto dacumes) [2] ave you overused any other name (e.g Nickname, malden name ais, Famiyname "avi th am of our earrent SpouR TC amONTG ten ares TOR OFFICE USEGNLY-D0 NOT WRTTEIN THES SPACE ‘Thisform made avalsble by nmigration, Refugees nd Clzenship Canada and isnot tobe oo applicants. LEN FRANCAIS IMM 5257) CanadaPERSONAL OETANS CONTINUED) [i] Hreyoupreveusy beennaridorinaconmarineranionmp? [00 [] Ve ‘vain youre Ses Common Peer Fate sen ant ome ape am 7 Nance [1] sve apo “Ta aT AN aT [NETSTAT Have you ate eat oma cainated wring agency Tost your poeareyntgimorrenen [ne [ver PASSPORT. [2] -Pepornanber TE] con oreo oie ode [F] -fertitn ora paper indy etna orang Mannie ta RAN neom nN Cte EL] SS [NATIONAL IDENTITY DOCUMENT [Tocyoutmesrtaieniyescmen’ Em [ve [a] becment mbar [3] coor orev ofa ae date [Tepiy ane L_ wer vane [Tire yous bw Permanent Resident ofthe United Sates witha vlan regntationcardigeencaret? L]*No [] *Ver [2 Ssconearnanbe Plena ‘CONTACT INFORMATION ‘Weubmitng your appiation by mall ™ilesrerpondeee il oto trader une: youlnat your el ade blow “inecaing an onal ares laure alleorespondence dud lean penal neematen to be set tothe eal adresyou spect “you iho authorize theese maton fom you appa toa epee, asa ema ah alates hs Sacto and onthe NNSA76 or. Carentan adress Po.box ron Sreetno Faw oui orto FromeiSaie [Posalcoue [oct 2 [Redenialeadress Sonearmalingaaret []se LC) ve etn recive scetrame (earowm county arTowaery Prowacesaie [Posatcoue — [oswer pe aa [a] Risa Tatephonene— TT concanus [Jer [ET Forno [ET ewaiaaare Llemsawus Conmcase No be Come iPirate ait DETALSOF VST TOCANADA [iJ sepsis omer bay “ion Fie an iT ‘orecey PO [a ra oR oT TT 1 moar =a ar 2 lpaaieatorome a spucaTion ve ouhaan pointing aves olgeorapweniptaina® ——]we LE] “Wer thesansmered ys eit yo hitter eden Fam ]estoray IPE 1 we lavrown coon ewe euptovment ee eo Oo TRE ST a a TT VF SATE POT BO TRON RTE ae CI Ta ‘SSnoeus anoyea'tstun/ omnia Dosthareaps Weted nowy oeayry ews te Hye weeps pone Dye oo our a Fema enema su 1 7 Faron “camara Prana Fram |r Canela re 2 75 arom Roa Tey Preaarine Fam a TE amputee 3 5 iva eave Tay ProvesGovernment Gouvernement ofCanada du Canada i+ APPLICATION FOR VISITOR VISA (TEMPORARY RESIDENT VISA) you ness more space for any section printout an adlional page containing the appropriate section, complete ans submit with your appeation, pee [a] wean [a] wares = PERSONAL DETAILS ee eran hun ery ppt imam anal show nou paper cen [2 Twaveyou eerasedanyotiernane(ea.Nickmne maKonsaneaianei? [Jw L] ve Tone ern bre [oan [5] rear [E] citizenship FTE RTE aa Ta Bie ar = FS ST TR TT TR a oT TTT aa [21 Smtipoyor are coger iy ene Oneaed shove omen ceo oO oO [2] compa Tamyahanapelay Rar wamnncoonywormmyatecaan L]'m C te Fh ere bf you are married or in a common-law relationship) Provide the date baal Seas ee ae ae ie Cae chenranes TOR OFACETREOR-B6 NOT WATETS TTA Thomas tei agen ip ours ela 7"PAce2085 rT Tote PERSONAL DETAILS CONTINUED) [i] tive you peony eenmariedevineconmortow anioatipy [Je [Je Poet foi ta oy pes pus onnonn Pre Jaonearoen aeTeRRS 7 7 wm op oe hie TaNuacet [BT te apenas Re ea DaR ST a aaa Tho gap oUaeE aT Ee PASePOAT Passport number ‘Country or teritory of issue [2] issuedare: [4] “expiry date oan sss 3 ors wnt apr aed oO na lfouen Narn Tenia aioe avoanionenneat Ete TE] Ae cane Coe Ci NATIONAL DeNTITYDOCUNENT [FToeyeutsearsondtinty oor CC] [2] document number [2] country orterrtory of sue [4] issue date [5] expiry date TErRCARD [Tee you tw Permanence ofthe United Staer wh aval alien eget cardigeen oa? [2] beairearnanber ‘CONTACT NFORMATION o gover ieretpondace wi gore hrs neyo rene your ema tes below Inctng ema nes il ahora al crespondencencsing lean peronlinomaton tobe seo headdress you pe “yooh shes ha uno craton em youapcaton 03 epesetti, ote thet mod snd malin sare nts etn enon the WAS376 fom, [Terenas Poe 1 co ry “Caron “canyon Tommie [rote Ruldentaladdresr Sorasrmeangacuea? [ [NL] ve Tate Sree etre anita ee orton Proms [Parcs [oar a oo [a Aieieeephonene TT crass one [S)Faene [i] emaaaaree Leones como Ha _ Dower ‘oct ons HA EAPO IDTV "tanceanot else coreseTCeAMENPAce0F5 [arreanrname Date ofeinh ‘DETANS OF VISITTO CANADA [2-21 rerpose of my wie [otter By Tron Te TB] Fanart ory ay CAO) youn rveaaeon remoo [Ravi eer areata Bay aon nsTURONS TWAT | framnonmipoe oe 2 lraiertiptome area EDUCATION Have ouhadany pst condaryeducatnfncudng uabery. cole orepprenicenptaking? "No L.] “Yes Hyosansmere yes ve fl tals of your highest lee gst serdar eden From awry Scoala mae 1 Te ranrtomn Ceaniy artery Fromenine EMPLOYMENT ie tas oT our Ne TTF Fa TOA I VOU Ne DIST GOVE po Gach Ge sean age, pokes oer aj Neer Paar ROTAT ‘nut emgojee ofa secuty oaniaton,Govetlere gps, Weed, not wosing or suing pase neat youre reves lease provide tha 10yers befor your Fam Caen Ren OCSROR F compavienloeuaciy are 1 7 “Gaviowm Caan orTetoy Frome From reiousatwigocapaon Eompar apoyo rome 2 Te erie Counter Teron Prowse From Prsiour n/a onpany/implyerF acy rane 3 Te om anor Tanton FroweaisaneParser ‘BACKGROUND INFORMATION ‘Yournust complet this setonityouare 18 years of geo older [T= wahin she past wo years, have you ora family member ever ha tuberculosis ofthe lunge or been in clots contact witha perton with ubercuose? De yeuhave any pyar mental dort tht woudrequie cl andrea snc ther han mtn, ing ay Canc ciyouanswered este question 1 1), pase provide das anthe name team member apie oO» Ove Os» Ove a Haveyou ever rained beyond the ally oyour satus, tended scool hou atheriaton or waked wihout authorationin Canad ‘ave you teow app er remain nCanaat aifyousnsnted yes to gunton 2a 29,0" 2; pleae prove deta Om Ove Cm Dye Ow Owe Have youever corms been rested, Been charged wah r conte ofan ermine in ary county ey by youanmered-yer toqunton 2s above pee prov deta O» Ov Bayou Ty a FS ence or see a Tegan PORTO OAT OT “oso nna secs orvelateerome? youaneredye to eston 4 pease prov ats of sete anc counts otros where yousered Os» Ove [Eye ate you rar baor srr azn any pal pry a aha rou or aration Wi Tat eigaped or VOT WTEC oO» Ow [ET ove you ever winessedorparcipatedin the resumen of prisoners rcillans looting or desecration oragiousbubings? Om Ove i rawered er to ay of quetons 1 6 above oF pn quent of vis oes, you MAY BEREQUINED to ilout NM257 SchedulePrana ate ofeith SIGNATURE tanip we iigatin Canada (OE aren egenaten av vee nay want to contac you inthe itr tacky abowt any sie youraceved om CK pros appiaton proces suchas parcpaten nan ermaten frum, diz te appiaton proces rug th appa roces sees wellas aon or ctedtaton services and ‘rics reed ate ating Cand nclang sete eatin acest) CCl eth iNormaton along wih the formation provide ctherndul fo ‘cinch potomance menurrent or craton puppote, wilt se stern toma ay dectone about you peo Doyeuconsentbecontacted byCcoranorganzatonarcicsreques.inthensurercem) = CJ» [8 | conne oth least CRzephip and migration Cana IC ane Canada order Sees iene (CSA of allrecors and wnat the pupa a prcesing my requasthat boy gorerment auto reluang pole del an stae authors nal courtsin whch fave ned may potas shout ne Tintmaton a even aerate my saab ‘oradsion Canada ro ema Canada pursuant Caradon EDSON, dee that have ansnered all questions inthis pation yan why Sqnstue of Appian or ueregel Gund’ or eon uncer 1 yer fae nes weresust.00 ‘Thieapplleation muctbe sgnad and dated before ite submited by mal Bonar orgetomcuge photos ee apical roy other camer equte Reve the appleatn guide or mre norman ed vei that you have ‘arsed on provided allo he reued docuentsas per the document che, ‘PRIVACY NOTICE Penal nation provided nth for colaced a wb ure ici and eae Inmiraton, efuoes and Citeship Cana (IRC) ude autor ofthe ign endetugu Petcon Ac) The personal norraton poise lib ne for the purpose of processing epplstons. The persnalinfrmatin provided ay be diosa other ent gesrment attuten anata pate: naudng bw enforcement bose, rover governs ano forgn governs rhe purpot of valtng en, sity and smitty. ne pesnalfoaton colectd onan aplton, ang other nformation calcein suport of an appaton may be sed for computer anasto support precersing of pplstins and Schon mating clang yes appeaten: Persenl eration incaing fom conper analy, may abe se fr purposes ncudng reese, atts, rogram and Poly elton, temalaud, complanceskmanaperent satay devlopment and epoin, nee bometsare roviedn supportof an aplion he ngrrins colcted ibe sore nsare withthe RCMP. The Mngrpintecor my ao be lowed tla enforcement eacesincansdan nconance mihsubsecon 13 ofthe rgmaon ae ieeyes rotten Regulston. Ths orton my be used stash vif thet of person er reves neste orpoveat an llr de a a of Canada or frvrc, TMs imaton Moyo be ued eb or vel te Key fannie Key oaet sera be oes establahod eevee cane phys metal eonsian, Canad ry es share mmigratininermaion reed tome recore ih oe) Soman ahichom Cinada hee anagtemento rangement Fatt comolte tefl ay et nay rhe pict not bg precnsed The Pac Act he ul height of acest, protection andconetion ofthe pusonalincmuten ure dette atari innfasau yu stent satified fh temmaner hich AC handles you personalntormaion you may err your rah f= Eomelant ste Dice fhe ancy Cammisana fama The colton we conte nd etentan our pana Nermaton further esrb CC's pesealiformation nk accross,