PROTECTED WHEN COMPLETED -B Pope tot 3 BOD ecient, TeRyemee Caece [Ee Resarom | Param | USE OF A REPRESENTATIVE ‘You do not need io hiro. representative, is your coice. No ane can quarantee the approval of your appicalien_ A tho om and infomation inal you need to epply ae available for ree at yowiccicacica A representative & semeore who has provided advice or qudance to yeu at any stage of the application process, whether that person received consideration (i. compersaticn) or not Folowing the submission of yeur appicatcn, thal person may conduct business on your behalf with Immigration, Refugees and CClizonchip Canada (ICC) and the Canada Border Sersieos Agoncy (CBSA) if you azpoint thor as your roprescniatve by filing out His forn. Tho procedng indudes Express Enty submssions. You may have ene representalve only per applcabon. ff You appeint an additional representaive, Ne previous reprosentatve wil ne bngor be authotizu to conduct business on you bohal at roclvo inforaon on your caso. Note: You must use tis form to appoint paid or unpaid reprosontative to conduct businoss with IRCC ortho CBSA on your behalt. You must also use tis form o:1-notiy IRCC your representative's cortact nformation changes, 2. if you wish lo cancel tho appointment of your current representative and represent youre! or, 3 you wish cance! the appointment of your carent representative and appoint a new representative appoining areprosentaive. Complete Sections A,B and D. 7 eanesting te appottinentot a representative, Complete Section A, C and D. [SECTION A! APPLICANT INFORMATION 4. Your fullname Family name (Sucname) ‘Given narma(s) larsnesep Kaur 2. Your date of birth [YYYY-Mv.00) 1996-6 3.Ifyou have already submitted your application: ame of office where te appcation was subsited “Type of apolcalion (permanent resiience.extansion of study peri, ec) 4, Unique Client identiner (UC) number (i K70%n) ‘SECTION 8: APPOINTMENT OF REPRESENTATIVE * authorize the fofowing indivkval to sen as my representa and te const businoss on my behalf with Immigration, Refugoos ane Citzonship CCanaca and Canada Border Services Agency. Note: Even ia representative's being part or compensated by someone other than you (the applicant), Ihe representative is sill considered tobe a compensated representative + authorize immigration, Refugees and Citizenship Canada end Canada Border Services Agency to elsase infration fom my case ie and thal of my “dapordent chidien under 18 years of ago to my fepresentatve. Ths authonzation isn aosordanos wit the Privacy Act + Lam aware that any information which would be subject fo exemption, 1 had the right of access uncer the Privacy Act or the Access to Information Act, vl likely not be reloasod 5. Your representative's full name amy nama (Surname) ‘wen namo(s) Irani lHemlata 6 Your representative (id one bx): (018 UNCOMPENSATED and is 8 Ci trond or aiy mentor [Ly manber tthe Colo ge or mmisrtion and Citzenshp Corsutans (i nolares du Qudboc Which province or tenor Memtersh 1D number 1CC), a Canadian provical or tertorial law society, o the Chambre des Caine (pics spacty) raspy rR HRS CEN Canada‘Save ] Reset Fom | Pint Form Page2ots oR (is, er wit be, COMPENSATED and is a member in good standing of [| the Cotege of rmaration and Cizorship Conant (CICC) ‘Merership 1D number fasas743 a cenadon provincial or tomtorial aw socity hish province or re | (eens Li the Chambre des notre du Quebec ‘Membership 1D number 7. Your representative's contact information Name o fim or ganization if applicable) [migrance conaulting « thnigration Tne I student tw, wie the name ofthe supervising lawyer ‘Supenising lanyer membership 1D Mating address ‘Aon Steotne. __Stetnamo [zoe fusos se margazets Say Rd, tyrtown, ProvinolStleTernion, Court ortentory Poste eosora | fnakeside frova scotia _| feanada ] [a2z_aaz Telephone number Country Code __Avea Gove and Telephone number i 19021 880-7800 Fox number Country Code ___ Area Code and Telephone number E-mail adress (tappioabe) neni atapunj@outloox. com By indicating your represortatve's e-mal address, you are hereby authorizing Immigration, Refugees and Citizenship Canada to transmit your fee end personal infomation to this specie oma edaross, 8. Your representative's declaration + | dociarothat th information in Secon B is tut, compote and caroct + Lunderstand and accept fat | am the person appointed by the apoicant to conduct business on the applicant or sponsor's behalf with Immgration, FRotugoos and Cilzonship Canata and Canada Border Services Agoncy 3-06-07 ‘Sghalro 0 Tepesontaive ‘SECTION: CANCEL THE APPOINTMENT OF A REPRESENTATIVE | witraw my authorization for this person to serve as my representatve, fo receive information on my ease hile and fo conduct business on my behalf with Immigration, Refugees and Citzanship Cenade and Canada Border Sen/ces Agency 9. Your representative's full name Family name (Surname) ‘Given name(s) Nam of fim or exganation (it ppcablo) Ina 75 (11.2021)Page sot ‘SECTION D: YOUR DECLARATION 10. Your declaration * | declare that | have fly and truthfully answered all questions on this form and any attached application ( applicable). * I elso declare thet | have read and understood all the statements on this form, having asked and obtained an explanation for every point that was not clear tome. PR 2023-06-07 ature of applicant Date OY FY-NEDDT gre OF Spouse OF Comar-law paper Tor SPORSGTENE BPETCRBON Warning! Itis a serious offence to give false or misleading information on this form. Personal information proved on ths form is collected by Immigration, Refugees snd Clizenship Canada (IRCC) under the authority ofthe Immigration and Rolugee Profection Act RPA) and of the Ctizership Act. The persenal information ofthe appant ie used for iertifcation and euthorzation purposes, The Personal information of te immigration representative is used to very thatthe representative Is authorized lo offer representation services according to the Provisions of IRPA and ofthe Citzenship Act, | The personal ormation of totn te applicant and the representative may be csclosed to oer federal government insttutons, non-goverimental and intr- {governmental organizations, regulatory bodes, investigative bodies, and provincialNeteril governments for he purposes of validating inti, formation, ‘23nd supporting an nvesigation. Personal information ofboth the applicant and the representative may be used for ather purposes including research, statistics, program end policy evaluation, internal uct. compliance, risk management, srstegy development and reporting, Flue to complete the fom in fl wil resi in a delay to processing. The Privacy Act gives individuals the right of access to, protecton, and correction of thet personal infomation. Ifyou are net satisfied wit the manner in which IRCC handles your personal information, you may exercise yout right to fie 2 complint tothe Office ofthe Privacy Comnissicner of Canada. The collection, use, disclosure and retention of your personel information i further deserved in RCC's Personal Information Bank -IRCC PPU 013, 042, 054, 068 a 5476 11-2003)