INFORMATION REQUIRED – WORK PERMIT

(Outside Canada)

1. Family Name: METZGER RAYMUNDO__________________________________

2. Given Name: THAIZ_________________________________________________
3. Have you ever used any other name (Nickname, Maiden Name, Alias, etc.)? Yes: □ No: □
If yes, please provide:
Family Name- METZGER RAYMUNDO VASCONCELOS Given Name- THAIZ

4. Current country of residence: -

Country Status From(yyyy-mm-dd) To (yyyy-mm-dd)
BRAZIL CITZEN 1988-21-08 2023
5. Previous countries of Residence which you have live: -
Country Status From(yyyy-mm-dd) To(yyyy-mm-dd)
USA LEGAL 2021-07-28 2022-09-19

6. Marital Status: - MARRIED ____________________________________________

7. If you are married provide the date: - 2021-03-25 __________________________
8. Name of your spouse (Given name and the family name) RAFAEL SALES LEITE____
___________________________________________________________________
9. Have you previously been married? YES___________________________________
Name of the spouse (given and family name), RAPHAEL VASCONCELOS D’ALMEIDA
Type of relationship- MARRIED
Date of birth of spouse: 1986/09/05
Duration of the relationship- from 13/02/2014 To 12/02/2019
________________________________________________________________________
10. Native Language: PORTUGUESE ___________________________________________
11. Current Mailing address with postal code -please give the house number, city and the district
ENGENHEIRO MAIA FILHO STREET – NUMBER 89 – ILHA DO GOVERNADOR – RIO DE JANEIRO RJ
– BRAZIL – ZIPCODE 21930330_____________________________________________
12. Current Residential address: ENGENHEIRO MAIA FILHO STREET – NUMBER 89 – ILHA DO
GOVERNADOR – RIO DE JANEIRO RJ – BRAZIL – ZIPCODE 21930330 ________________
13. Home Telephone# ____________________Cellular # +55 21 981746314____________
14. E-mail address: Thaiz_metzger@hotmail.com
15. Education (provide ONLY your education which you can provide proof)
From – TO Name of the degree/certificate Name of the school City and country
yyyy/mm yyyy/
mm
2005/02 2007/12 HIGH SCHOOL COLÉGIO LONDON Rio de Janeiro -
RJ Brazil

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2010/07 2016/07 COLLEGE - BACHELOR'S DEGREE IN PONTIFICAL CATHOLIC Rio de Janeiro -
ARCHITECTURE AND URBANISM UNIVERSITY OF RIO DE JANEIRO RJ Brazil
2022/06 2023/01 COLLEGE (STUDYING) - SUPERIOR IBMR UNIVERSITY CENTER Rio de Janeiro -
TECHNOLOGY IN GASTRONOMY RJ Brazil

16. In the last 5 years all countries of visit even if you have visited for one day: -
From(yyyy-mm-dd) To(yyyy-mm-dd) City/Town and Country Type of Visa
2021-07-04 2021-07-28 BOGOTA-COLOMBIA MERCOSUL

2021-07-28 2022-09-19 NASHVILLE-USA J2

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 17.Have you ever applied for any kind of visa to Canada or to any other country (e.g. PR, Work
permit/visit/student visa) YES – J2 VISA ______ ______________________________________
a) If yes provide details such as name of country with dates and file No./UCI number.
USA – 0211889490002__________________________________________________________
_____________________________________________________________________________
18. Have you ever been refused for any kind of visa to Canada or to any other country(e.g. PR,
Work permit/visit/student visa)) NO
a) If yes provide details with dates and file No./UCI number. ____________________________
_____________________________________________________________________________

19. Have you ever overstayed in any country without status or beyond validity of your visa? NO
a) If yes provide details with dates _________________________________________________
_____________________________________________________________________________
Disclaimer: Canada shares immigration and personal data with several countries including the USA. Any individuals with
adverse immigration history will show on the Canadian immigration system. We strongly urge you to disclose any previous
refusals and/or overstays in any country.
20. Details of your personal history since age 18. Do not leave gaps between periods, if you were
unemployed, on vacation please mention. If you are retired please provide information prior to
retirement.

From – To Current Occupation/ Name of the company/ City and Country

(yyyy-mm) Activity Employer/college
2008/02 to 2010/05 SECRETARIAL DI MAGGIO EDUACIONAL Rio de Janeiro - RJ
ASSISTANT CENTER Brazil
2010/07 to 2011/06 COLLEGE - PONTIFICAL CATHOLIC UNIVERSITY Rio de Janeiro - RJ
STUDYING OF RIO DE JANEIRO Brazil
2011/06 to 2011/12 COMPLETION OF ELECTRONIC CEBRAC ILHA INSTITUTE Rio de Janeiro - RJ
MODELING COURSE WITH
RENDERING Brazil
2012/01 to 2012/06 COLLEGE - PONTIFICAL CATHOLIC UNIVERSITY Rio de Janeiro - RJ
STUDYING OF RIO DE JANEIRO Brazil
2012/07 to 2012/12 INTERN ARCHITECT LOCAL OFFICE RESIDENTIAL Rio de Janeiro - RJ
ARCHITECTURE AND INTERIORS Brazil
2013/01 to 2013/07 ASSISTANT AND PLASTICA OFFICE ARCHITECTURAL Rio de Janeiro - RJ
MODELER MODELS Brazil
2013/08 to 2015/02 INTERN ARCHITECT SUSSMANN ARCHITECTURE AND Rio de Janeiro - RJ
URBANISM OFFICE Brazil
2014/02/13 GOT MERRIED Rio de Janeiro - RJ
Brazil
2015/03 to 2015/06 COLLEGE - PONTIFICAL CATHOLIC UNIVERSITY Rio de Janeiro - RJ
STUDYING OF RIO DE JANEIRO Brazil
2015/07 to 2015/12 INTERN ARCHITECT FINGERS ARCHITECTURE AND Rio de Janeiro - RJ
DESIGN Brazil
2016/01 to 2016/02 ADMINISTRATIVE CIVIL ENGINEERING DEPARTMENT - Rio de Janeiro - RJ
ASSISTANT PONTIFICAL CATHOLIC UNIVERSITY Brazil
OF RIO DE JANEIRO

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2016/03 to 2016/06 COLLEGE - PONTIFICAL CATHOLIC UNIVERSITY Rio de Janeiro - RJ
STUDYING OF RIO DE JANEIRO Brazil
2016/07 GRADUATE IN PONTIFICAL CATHOLIC UNIVERSITY Rio de Janeiro - RJ
COLLEGE OF RIO DE JANEIRO Brazil
2016/08 MOVED TO AN Balneário Camboriú - SC
OTHER STATE Brazil
2016/09 to 2017/08 ASSISTANT AND WL MODELS Balneário Camboriú - SC
MODELER Brazil
2016/12 to 2018/02 ARCHITECT AND A3 ARCHITECTS OFFICE Balneário Camboriú - SC
PARTNER Brazil
2019/02/12 DIVORCED AND MOVED Balneário Camboriú - SC
TO AN OTHER STATE Salvador - BA - Brazil
2017/02 to 2020/07 GRAPHIC DESIGNER, MCS MARKETING Salvador - BA - Brazil
ARCHITECT, PROJECT CONSULTING SPORTS
COORDINATOR.
2020/02 MOVED TO AN Rio de Janeiro - RJ
OTHER STATE Brazil
2020/07 to 2020/12 PANDEMIC Rio de Janeiro - RJ
LOCKDOWN Brazil
2021/

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 21. Details of proof of funds: - (money value of fixed assets)

Name of the Bank Value in Can $

22. a. Within the past two years, have you or a family member ever had tuberculosis of the lungs or
been in close contact with a person with tuberculosis? q No q Yes
b. Do you have nay physical or mental disorder that would require social and /or health services,
other than medication, during a stay in Canada? q No q Yes
c. If you answered “yes” to question 22a or 22b, please provide details and the name of the
family member?
23. a. Have you ever remained beyond the validity of your status, attended school without
authorization or worked without authorization in Canada or any other country? q No qYes
(Kindly answer this question as accurately as possible, since Canada Immigration has access to all
embassies and is able to gather information on you as soon as you provide biometrics at the time of work
permit application. Any information that is not truthfully answered will be questioned by Immigration which
will result in a negative manner)
b. Have you ever been refused any kind of visa, admission, or been ordered to leave
Canada or any other country? q No q Yes
c. If you answered “yes” to question 23 a or 23 b please provide details.

24.a. Have you ever committed, been arrested for, been charged with or convicted of any
criminal offence in any country? q No q Yes
b. If yes please provide details.
25. a. Did you serve in any military, militia or civil defence unit or serve in a security organization or
police force (including non-obligatory national service) q No q Yes
b. If yes, please provide details.
26 Are you or have been a member or associated with any party, or other group or organization
which ahs engaged in or advocated violence as a means to achieving a political or religious
objective, or which he has been associated with criminal activity at any time? q No q Yes
27. Have you ever witnessed or participated in the ill treatment of prisoners or civilians, looking
or desecration of activity at any time? q No q Yes

28. FAMILY INFORMATION -

Please list all family members. If any of the family relatives are deceased, please give city and date.
DATE OF
PLACE PRESENT ADDRESS
BIRTH MARITAL
NAME RELATIONSHIP OF
DD/ STATUS
BIRTH OCCUPATION
MM/YY
SPOUSE

MOTHER

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 FATHER

SON

DAUGHTER

29. FAMILY INFORMATION - BROTHERS AND SISTERS

PRESENT ADDRESS
DOB PLACE OF
NAME RELATIONSHIP MARITAL
DD/MM/YY BIRTH OCCUPATION
STATUS

IMPORTANT NOTE:
ALL RESIDENTS WORKING IN UNITED ARAB EMIRATES AND MIDDLE EAST (GULF), KINLDY NOTE THAT
YOU ARE REQUIRED TO ACCUMALATE YOUR VACATION DATES. THUS, PLEASE DO NOT TAKE ANY
VACATION TIME OFF WITHOUT CONSULTING US.
I hereby confirm that I understand and have disclosed all information accurately and correctly to the
best of my knowledge.
………………………………………… ………………………..
Name & Signature Date