Application Summary Group Information

Naguin Julianne Velasquez Vanegas (V400495395) Protected B
Application Summary
Group information
Do you want to apply for more than 1 person at the same time? No
Application for a visitor visa
I want to apply for a: visitor visa or supervisa
To visit other family who are not listed above or friends for
Why do you need a visa?
less than 6 months
I will go for tourism and to visit my cousin. I am planning to

visit Toronto, Ottawa, Niagara Falls, and Montreal. I will be
Tell us more about what you'll do in Canada. Include dates.
traveling to Canada on August 1, 2022 and returning home by
September 1, 2022.
When will you enter Canada? 2022-08-01
When will you leave Canada? 2022-09-01
Representative
Are you applying on behalf of someone else? No
Date modified: 2022-05-14 04:34:00 UTCZ Page 1 of 11

Travel document information of the applicant
Surname/last name Velasquez Vanegas
Given name/first name Naguin Julianne
Date of birth 1999-05-18
Gender Female
What document are you travelling with? Passport
What kind of passport? Regular
Select the country code that matches the one on your passport NIC (Nicaragua)
What's the nationality on your passport? Nicaragua
What's your passport or travel document number? C02594201
Confirm your passport or travel document number C02594201
When was the passport issued? 2019-04-15
Date of expiry of the passport 2029-04-15
Are you a lawful permanent resident of the United States with a valid Green Card (alien
No
registration card)?
Have you held a Canadian visitor visa in the past 10 years? No
Do you currently hold a valid U.S. nonimmigrant visa? Yes
Nonimmigrant visa number J2120243
Expiry date 2024-05-01
Are you using a different passport for this application than the one you used to get your U.S.
Yes
nonimmigrant visa?
Select the country code that matches the one on your passport NIC (Nicaragua)
What's your passport or travel document number? C01659200
Confirm your passport or travel document number C01659200
When was the passport issued? 2014-04-14
Date of expiry of the passport 2019-04-14
Are you travelling to Canada by air? Yes

Citizenship and places where the applicant has lived
Country or territory where you were born Nicaragua
City or town where you were born Managua
Are you a citizen of more than one country or territory ? No
Which country or territory are you a citizen of?
Country/territory of issue Nicaragua
I am a citizen of this country or territory since birth
From 1999-05-18
National identity document of the applicant
Do you have a valid national identity document? Yes
Document number 0011805991015E
Confirm your document number 0011805991015E
Date of issue 2015-10-23
Select the country or territory that issued this document Nicaragua
Names used in the past
Have you used another name in the past? No
Contact information of the applicant
Bosques de Nejapa, Casa G- 102, de la rotonda el periodista

900 mts al sur frente a radios COASA
Address
Managua 13034
Nicaragua
Is your mailing address the same as your residential address? Yes
List your current country or territory of residence, then add all other countries or territories where you've lived for the past five
years, for more than 6 months.
Country/territory Nicaragua
Status Citizen
From 1999-05-18
This is where I currently live.
Biometrics (fingerprints and photo) of the applicant
Do we already have your fingerprints and photo (biometrics), and are they still valid? No

Invitation
Who is inviting you?
Surname/last name Velasquez
Given name/first name Othar
Relationship to you Family member
23 Hillbrook Cres
Mailing address Kitchener Ontario N2N 1J4
Canada
Telephone number
Telephone type Cellular
Select telephone number country or territory Canada/US
Telephone number 8073566688
Email address othvelvan93@gmail.com
Has someone else also invited you? No
Finances
How much money do you have for your stay in Canada? (In Canadian dollars - CAD) 7500
Is someone else giving you money for your stay in Canada? No

Information about education, work and other activities
Post-secondary education history
Have you ever studied at a post-secondary school (university, college or vocational school)?
Yes
You don't need to have completed a degree or diploma.
Give details of each program you have studied and are

Universidad Americana (UAM)
currently studying.
From 2016-02
Level of study University - Bachelor's Deg.
Field of study Medicine
To 2021-08
Costado Noroeste Camino de Oriente

Address Managua
Nicaragua
Work/activities history
Military/police history
Did you serve in any military, militia, civil defence unit, security organization or police force
No
(including non-obligatory service, reserve or voluntary units)?
Give details of all your employment and activities since the age of 18.
From 2021-02
Ongoing
Work/Activity Health occupations
Job title Other technical occupations in health care
Company/employer Dental Clinic SIM
Main duties of the job Provide dental care services for the community
De las Tejitas 1 cuadra al sur

Address Chinandega
Nicaragua

Travel history
During the past 5 years have you travelled to a country or territory other than the one where
Yes
you're a citizen or where you live now?
From 2021-10
To 2021-11
Country/territory United States of America
Location/place where stationed Miami
Purpose of travel Tourism
From 2021-09
To 2021-10
Country/territory United States of America
Location/place where stationed Miami
From 2018-02
To 2018-02
Country/territory Cuba
Location/place where stationed La Havana
Have you ever stayed in Canada beyond the validity of your status, attended school in Canada
No
without authorization, or worked without authorization in Canada?
Have you ever been refused a visa or permit, denied entry to, or ordered to leave any country or
Yes
territory?
Provide as many details as possible about when that In 2012, I applied to visit Canada but my visa was refused,
happened and why. This will help with processing your the letter said I did not meet the requirements based on my
application. family ties and purpose of visit.
Criminality and security
Have you ever committed any crime in any country or territory (this includes driving under the
No
influence of alcohol or drugs)?
Have you ever been arrested for any criminal offence in any country or territory (this includes
No
driving under the influence of alcohol or drugs)?
Have you ever been charged for any criminal offence in any country or territory (this includes
No
Have you ever been convicted for any criminal offence in any country or territory (this includes
No

Criminality and security questions
Are you or have you ever been a member associated with any political party, or other group or
organization which has engaged in or advanced violence as a means to achieving a political or No
religious objective, or which has been associated with criminal activity at any time?
Have you ever witnessed or participated in the ill treatment of prisoners or civilians, looting or
No
desecration of religious buildings?
Medical background questions
Have you had a medical exam performed by an IRCC authorized panel physician (doctor) within
No
the last 12 months?
Medical background questions- Tuberculosis
In the last 2 years, were you diagnosed with tuberculosis? No
In the last 5 years, have you been in close contact with a person with tuberculosis? No
Medical background questions
Are you currently receiving dialysis treatment? No
Have you had a drug or alcohol addiction causing you to be a threat to yourself or others, or to
No
be hospitalized?
Have you had a mental health condition causing you to be a threat to yourself or others, or to
No
be hospitalized?
Have you ever been diagnosed with syphilis? No
Family information
What is your current marital status? Single
Children
Do you have any biological, adopted or step-children? No
I understand that I am not declaring any natural, adopted or step-children.

Tell us about your parents
Surname/last name Vanegas Narvaez
Given name/first name Ana del Carmen
Relationship Mother
Country or territory of birth Nicaragua
Present occupation Risk Manager
Does this parent have the same address as you? Yes
Will this parent come with you to Canada? No
Surname/last name Velasquez Martinez
Given name/first name Guillermo Antonio
Relationship Father
Country or territory of birth Nicaragua
Present occupation IT Consultant
Does this parent have the same address as you? Yes
Will this parent come with you to Canada? No
Language of the applicant
What is your native language or mother tongue? Spanish
Can you communicate in English and/or French? English
What language do you want us to use to contact you? English
Email address of applicant
Email address naguinv@gmail.com
Confirm your email address naguinv@gmail.com

Telephone number of the applicant
Telephone type Cellular
Select telephone number country or territory Other
Telephone number +505 84363556
Telephone type Residence
Select telephone number country or territory Other
Telephone number +505 22790495

Documents to support your application
Document name Letter of invitation
File name Invitation Letter Naguin Julianne Velasquez Vanegas.pdf
Size of the Document 328.00 KB
Date/time uploaded 2022-05-12 04:34:00 UTCZ
Document name U.S. non-immigrant visa
File name visa-USA_NaguinVelasquez.pdf
Document name National identity document
File name National identity document Naguin Julianne Velasquez Vanegas.pdf
Document name Passport/travel document
File name Passport travel document Naguin Julianne Velasquez Vanegas.pdf
Document name Employer letter (current)
File name Employment Letter Naguin Julianne Velasquez Vanegas.pdf
Document name Additional documents
File name AdditionalDocuments-Naguin Velasquez.pdf
Fees
Fee Quantity Price Total
Visitor visa 1 CAN$100 CAN$100
Biometrics 1 CAN$85 CAN$85
Total CAN$185
Consent and declaration

Citizenship and Immigration Canada (CIC), or an organization at CIC's request, may want to contact you in the future to ask you
about any services you received from CIC prior to the application process (such as participation in an information forum), during
the application process (including the application process itself as well as orientation or accreditation services), and services
received after arriving in Canada (including settlement, integration and citizenship). CIC will use this information, along with the
information provided by other individuals, for research, performance measurement or evaluation purposes. CIC will not use this
information to make any decisions about you personally.
Do you consent to be contacted by CIC, or an organization at CIC's request, in the future? Yes
I consent to the release to Citizenship and Immigration Canada (CIC) and Canada Border Services Agency (CBSA) of all records
and information for the purpose of processing my request that any government authority, including police, judicial and state
authorities in all countries in which I have lived may possess about me. This information will be used to evaluate my suitability
for admission to Canada or to remain in Canada pursuant to Canadian legislation.
I declare that I have answered all questions in this application fully and truthfully.
Signature of Applicant or Parent/Legal Guardian's for a person under 18 years of age.
Surname/last name Velasquez Vanegas
Given name/first name Naguin Julianne
Privacy Notice
Personal information provided on this form is collected and will be used, disclosed, and retained by Immigration, Refugees and
Citizenship Canada (IRCC) under the authority of the Immigration and Refugee Protection Act (IRPA). The personal information
provided will be used for the purpose of processing applications. The personal information provided may be disclosed to other
federal government institutions and third parties including law enforcement bodies, provincial/territorial governments and/or
foreign governments for the purpose of validating identity, eligibility and admissibility.
The personal information collected on an application, and other information collected in support of an application, may be used
for computer analytics to support processing of applications and decision making, including your application. Personal
information, including from computer analytics, may also be used for purposes including research, statistics, program and policy
evaluation, internal audit, compliance, risk management, strategy development and reporting.
Where biometrics are provided in support of an application, the fingerprints collected will be stored and shared with the RCMP.
The fingerprint record may also be disclosed to law enforcement agencies in Canada in accordance with subsection 13.11(1) of
the Immigration and Refugee Protection Regulations. The information may be used to establish or verify the identity of a person
in order to prevent, investigate, or prosecute an offence under any law of Canada or a Province. This information may also be
used to establish or verify the identity of an individual whose identity cannot reasonably be otherwise established or verified
because of physical or mental condition. Canada may also share immigration information related to biometric records with
foreign governments with whom Canada has an agreement or arrangement.
Failure to complete the form in full may result in a delay or the application not being processed. The Privacy Act gives individuals
the right of access to, protection, and correction of their personal information. Further details are available in Info Source. If you
are not satisfied with the manner in which IRCC handles your personal information, you may exercise your right to file a
complaint to the Office of the Privacy Commissioner of Canada. The collection, use, disclosure and retention of your personal
information is further described in IRCC's personal information bank - IRCC PPU 068.

Application Summary Group Information

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Application Summary Group Information

Uploaded by

Copyright:

Available Formats

Naguin Julianne Velasquez Vanegas (V400495395) Protected B

Application for a visitor visa

I want to apply for a: visitor visa or supervisa

I will go for tourism and to visit my cousin. I am planning to

When will you enter Canada? 2022-08-01

When will you leave Canada? 2022-09-01

Are you applying on behalf of someone else? No

Date modified: 2022-05-14 04:34:00 UTCZ Page 1 of 11

Travel document information of the applicant

Surname/last name Velasquez Vanegas

Given name/first name Naguin Julianne

Date of birth 1999-05-18

What document are you travelling with? Passport

What kind of passport? Regular

What's the nationality on your passport? Nicaragua

What's your passport or travel document number? C02594201

Confirm your passport or travel document number C02594201

When was the passport issued? 2019-04-15

Date of expiry of the passport 2029-04-15

Have you held a Canadian visitor visa in the past 10 years? No

Do you currently hold a valid U.S. nonimmigrant visa? Yes

Nonimmigrant visa number J2120243

Expiry date 2024-05-01

What's your passport or travel document number? C01659200

Confirm your passport or travel document number C01659200

When was the passport issued? 2014-04-14

Date of expiry of the passport 2019-04-14

Are you travelling to Canada by air? Yes

Date modified: 2022-05-14 04:34:00 UTCZ Page 2 of 11

Citizenship and places where the applicant has lived

Country or territory where you were born Nicaragua

City or town where you were born Managua

Are you a citizen of more than one country or territory ? No

Which country or territory are you a citizen of?

Country/territory of issue Nicaragua

I am a citizen of this country or territory since birth

National identity document of the applicant

Do you have a valid national identity document? Yes

Document number 0011805991015E

Confirm your document number 0011805991015E

Date of issue 2015-10-23

Select the country or territory that issued this document Nicaragua

Names used in the past

Have you used another name in the past? No

Contact information of the applicant

Bosques de Nejapa, Casa G- 102, de la rotonda el periodista

Is your mailing address the same as your residential address? Yes

This is where I currently live.

Biometrics (fingerprints and photo) of the applicant

Date modified: 2022-05-14 04:34:00 UTCZ Page 3 of 11

Who is inviting you?

Surname/last name Velasquez

Given name/first name Othar

Relationship to you Family member

Select telephone number country or territory Canada/US

Telephone number 8073566688

Email address othvelvan93@gmail.com

Has someone else also invited you? No

Is someone else giving you money for your stay in Canada? No

Date modified: 2022-05-14 04:34:00 UTCZ Page 4 of 11

Information about education, work and other activities

Post-secondary education history