•

Immigration, Refugees
o_/
Immigration, R6fugi6s
and Citizenship Canada
et Citoyennet~ Canada PROTECTED WHEN COMPLETED - B

Page 1 of 7
SCHEO'ULE 2
The princip ~~i~an ~!~!chc tUTSID beE
mi Y mem r 18 years of age and older must complete their own copy
CANADA .
1AM D The principal applicant of this form.

'[{) A lamily member

FAMILY
NAME :<hctli•1 i GIVEN
NAMES r,.:,:,nit e1 DATE (YYYY-MM-OO)
OF.BIRTH· l ~•71:- ~- -27
Provide as much detail as possible when answering the fonowing questions.

If you need more space attach a separate sheet of panor M k

..a. d.d.
top and number ea.,., a tbonal sheet. ,--• • a e sure you in dicate the form•s title
·
and the number or letter of the question you are answering Print your name at the
•
Family ~ r : A famrly me~ber is a spouse or common:Iaw partner.
accompany ing on the application). a biological or legally adopted child or a grandchild (providing that the parent of your grandchild is also

NOTE TO FAMILY MEMBERS 18 YEARS OF AGE AND OLDER:

If your answers are the same as the principal applicant's answers. write "same
as principal applicant" in the space provided after each question.
To be eligible fortesettlement to Canada as a refugee, at ie·ast one member
of the family must demonstrate the following:
• That1hey:

0 have a well-founded fear of persecution. for reasons of race. religion. nationality.

pohbcal oprnron or membership in a particular social group and are outside all
of their countries of nationality and that ·they are unable or. by reason of that
fear, unw1lhng to avail themselves of the protection of each of those countries.
OR

o have been. and continue to be. seriously and personally affected by civil
war. armed conflict or massive VIOiation of human rights ,n each of thew countnes
nationality and habitual residence of

AND
..
• That they are a person with no reasonable prospect. w1th1n a reasonable
penod. of a durable solution m the CQuntry of nanonahty (VQluntary repatnanon)
asylum (local integration) or If\ any country other than Canada (permanent resettlemen . ,n the country of
t).

PARTA
C-A~ 'NARRATIVE:
AU of the informatio n you provide most be complete. accurate and
true. It is your responsibility to ensure the reliability of any other person
translate or write this informatio n. If .you are found to have provided that helps you to
incomplete . inaccurate. or untruthful information in answer to any question.
aoolicatio n mav be refused your

Please ctescrioe in as much detail·as possible the specific ·events which

led you to~ your homo country. You should include any actions ~
against you. your family members, or any others in a similar situation. n
If the events were generalized. please describe how they affected you
personally or what led to you fearing for your safety. You should also
indicate whether you sought protection from the authorities of your country
not. why not. For each incident, specify the date (month / year) the and if
event(s) occurred.
My r,alll':- L:· ~~ONIF'.A K:lALJrjI. I c~III 47 y.:-<>u; .-lrl, -111,·I
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W A) Please describe in chronolog ical order when exactly you and your family
members left your home and w~at route you took. 'Expl8!n the mode
transporta tion taken. the types of vehicles or air1ines used. flight numbers. of
the date of tra~el. how you patd for travel. e~c. If you dtd not leave
.together, please explain the route each family member took and the
reason(&) why you did not travel togethes: Please include a copy of your
passport stamp of when you entered the country (if available). Please
indicate whether someone planned your travel or helped you leave or
enter
a country and how much you paid.
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IMM 0008 (10-2022) E (DISPONIBLE EN FRAN«;AIS - IMM 0008 F)

Cclnada
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Page 2 of 7

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B) Are you able to return to your home country? If not. why?

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C) Since arriving in the country where you are living now. have you returned to your country of origin, even briefly? If yes. how many times and under
what circumstances? Do you maintain property, a business or are you currently employed in your country of origin?
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A) In the country where you are living now, do you have the right to work. go to school or move freely? Are these rights available to you? Are you
residing in a refugee camp or in an urban area? Please explain.
;•/"= ,j,_, n,: t hav1:-- tis":: l iyi1t t.:• 9,:, t: ,:, s,:::h,:,:,l ._,r ·,.:•:,1 :,r 111:•V": ft,-,,s-1 y i.1 !:~ ·,;.:: d., n,,- t,,~V':, ·;:. =, <:'. . ; l • f ·~ l 1-. ,:11:1 "cn t :, ti,.. n.:;. TL-=
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B) Since arriving in the country where you currently live. how have you supported yourself and (if applicable) your family?
My ti".'( jall•J:H'::1$ 'Aft : 1 ,'tl':: in (ane.dci end 1Jr1it1"::d ?Zin,yi :-m hdV':- Stnl t":: J .:• u1.•i:· :, 1::. n,__r u:; f:.i. ,11-·~,'\lt'.; .• : .·.- l1 ..1V"- -·:-- .:..nr: ..111 =~ '.'
:-..::ivi11 J.c; l.\':·,i,:;!1 \,!'.; h.::.•i.

If thore Js nny other information that you think might be relevant to your ~se. pteose attnch a separ::ate page.

-PART B: fMMIGRATlON STATUS & SETTU:MENTABIUTIES

l:J A) Have you ever previously applied for resettlement under Canada's Refugee and tt •YES", .Jnswer (8) and (C)
Humanitarian Resettlement program? 0Yes (t]No
below. If •No", proceed to
question 6.

B) When and where did you apply? What was the result?

C) Have your circumstances changed sin.ce you applied previously? If so. please describe how.

L!J A) Have you ever been refused refugee status by .iny country including lhb country [ZJNo
where you are currently living? 0Yes

B) Other than this application. do you currently have a refugee status applicatio_n_in
proceu in any other country including the country where you are currently ltving? D Yes [{] No

If you antawered NYES" to either question. please provide as much detail as possible. including dates. places and description of circumstances.

IMM 0008 (10-2022) E

 Page 3 of 7

" C) Have you ever-applied for refugee status with the United Nations High
Commissioner for Refugees (UNHCR) in any country? 0Yes [ZJNo

If you answered "YES". what was the result and if possible, include a copy of all documentation received from the UNHCR and I or country regarding
any refugee claim. If applicable and available. please include a copy of the refusal letter.

. . .. . .. . .. . .. . ' . .. . . . .. .

0) Do you turtetitly have an applicatioh "f'or immigration ih prbcess lo any couhlry

(e.g. family reunification or economic categories)? 0Yes [ZJ No

If yes. please explain.

wAl What is the immigration status of you and your family members in your current country of residence (e.g.. citizen. permanent resident visitor.
refugee. no fegal status. -other)? Please provide documentation as proof of this ·status if availabte.

11) Do you speak, read. write or understand EngUsh or French?

English French
High Moderate Low None High Moderate Low None
Speak 0 Speak D 0
Read 0 Read 0
Write 0 Write 0
Understand 0 Understand 0
C) Please indicate atl tanguages that you are able to speak moderatety well or better.

.::rid IJzt':-ld
rri

I
0) (;ive examples of any work experience. skills and I or personal qualities that would assist you in successfully settling in Canada.

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PART C: ADDITIONAL FAMILY INFORMATION

Enter ALL names in English and in your native language (for example. Arabic. Cyrillic. Chinese. Chinese commercial/telegraphic code, Korean, or
Japanese characters). If additional space is required attach a separate sheet. If this section does not apply to you, write "Not applicable".

• Write the personal details in the boxes below for:

• yourself;

• your spouse or common-law partner;

• your mother; and

• your father.

You must answer all questions. If this section does not apply to you, answer "NIA" for Not Applicable.

IM 0008 (10-2022) E
 /
I

I
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Page 4 of 7

Name Date of birth City I Town and Date of death. if

Relationship Marital status deceased
(YYYY-MM-00) Country of Birth Present Address Email Address
(YYYY-MM-0D)
~: t ·:-"- r: : l ,
Mv11i r a Fd 1 yal:•,
:i '.tJ.;;':, l: J ,
Yourself l c,7,~- l.2-.::7 .-:~111 i .JiahJ:1,.1·:ll.2 :4 5 l
A t•Jhdl I i.>tdl I
Ma1ri':c-d F--11/.~
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I.:;la:r-:ib,,-J
P:lki !; tM1
Stl'::':-t 1,
Your spouse or :-l :-u.s,;- l i.J ,
Fa ry;ib, :.:.1cd i<:Ji,-,_hf!,.~: :i: J4 '.JJ
: Ll~ I
common-raw M,H l i,;- I 2-i 1n
partner Af•Jh,=tnbtan r_1m.., 1 l
. c • :n
hl-:=trcaC-:,•:i
F"<,kist:tn
Fa1:ydb,
Mother \IJi J .. ·,.,<:-d Af•_rh.1ni.=· t"n
Af,01hc1nisto:H1
Murt,;z,~qul
j.J ...,-4-iµ
F-.:1 ry.1b,
Father i ~· 4 ,)- 11 -1) 2 ~i/ A
Af9hc1r.i:;t~rn

CHILDREN

Write the personal details in the boxes below for all the following persons. including:
• all children (adult and minor} regardless of their marital status (married. single. widowed. divorced). regardless of their current location and
regardless of their status in Canada (permanent resident or citizen):

• aaopted children:
• children of your spouse or common-law partner for whom you are not the biological parent (step-children):

• any of your children who have been adopted by others:

• any of your children who are in the custody of an ex-spouse. former common-law partner or other guardian:

• any children who are missing. deceased or presumed deceased.

You must answer all questions. lfthis section does not apply to you, answer ..NIA"' for ·Not Applicable. ff you require more space, please
either.add 1fnes·to the form by'tlit'k'ing the+ buttol'dO the"iighl bt attach as~t,ar~te !th~el with t~ ~dclllional1amily'meihbet'S.
Date of death ,r
Date of birth City ' TOY(fl and Marital status deceased Present Address Email Address
Name Relationship (YYYY:MM-00) Country o; Birth (YYYY•MM-00)
_, Ev-tt1.•n
l ti•.;...,.,
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IMM 0008 (10·2022) E

 ,
•. r Page 5of7

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BROTHERS AND SISTERS

below for:
Write the personal details in the boxes and sister s who have been
. adopted brothers and sisters. broth ers
• brothers. sisters. half-b rothe rs. half-sisters, step-brothers. step-sisters and regar dless of their curre nt wher eabo uts.
ed. divorc ed)
al status (married. single. widow
adopted by others. regardless of marit
ing/ deceased-or presumed deceased.
• any brothers and sisters who are miss
ire more spac e, pleas e
"N/A" for Not Appl icabl e. If you requ
secti on does not apply to you, answ er
You must answer all ques tions . If this sepa rate shee t with the addit ional famil y mem bers.
the + butto n to the right or attac h a
eithe r add lines to the form by clicki ng
Date of death. if
Date of birth City I Town and deceased Present Address Email Address
Relationship Marital status
Name {YYYY-MM:DO) Country of Birth (YYYY-MM-DD)

Fa.t:y <'lb,
1.~,7~ 1-01-0 1
Af•Jl1 nni s t.:sn

Fc\ry ab, 2C2 3-,· 7-2':: Afi..1:1.'ln:.::;t nn '.'i.u.

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l!!J RELATIVES IN CANA DA

living in Canada .
Write the personal details of·all relatives
.. shee t with the
ing the + butto n to the right or attac h a sepa rate
r add lines to ·the form· by click
ff you requi re more space, please ·eithe
additional relatives in Canada.

Name Relationship Telephone No Current City and Provmce of Residence Email Address

( 2 L l,) .'1 1 EV•· lt it, Liiv. ,. NL!::

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g \o th e er a n d •n '-' • I IS CO\\ I
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li a n re la
te d to : re q u ir e
• yo u r -: e ~ u se e c, e d b y \m ==~~
~ -- -- --
• ident.t.., d fo r \h e • -- -- -_
in cl d' PU(l)O":!r _ :~ ~ ~
., , . o l lh e Act ~\i~n. R: e! ~~~~
yo u r re se u mg an . a n d to fa ug ees and C P :a g :e
tt \e m e n \ c il it a ~ :: iti zens • ~6~o
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• in fo rm ~ n d mak .,., .
a ti o n y o in
u h ;: e d Y p e rs o n a \ in fo ement in
g a d .: :;
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s ~ \a \e d rm a tio n if Canada if CC) _under
o \h e U Pf'Ovtded to yo u r im m e d "Ou your
ap
\he author
ity f
7
in \n\erv ia are selectphca\ion for p e rm
\h e N H C R ;ews \o a t: ; y~ur imm\gra '
ed. "" - ot the
o m i e a .\h n\ ca se fl\e:
p u rp o se r a n o e r re an d safetv: -= n
o f re feth m n n raf-.t.er,..ra\ o r . . .gta\\on officer. and
o \h e \n
\e m \i l:t ~.
. g-aniza\io . includin
a ona\ O "' lle es· n w tt h whi •
rg a n iz a ti ch the M'1n g co pi es o f su
o n fo r• M · ._ pporting
0 a n y o rg ig ra tio n: ISu:sr o f docum
• • \R C C h
C a n a d aa rn za tio n ents. may
u
o a n y s (\ R C C ) to e r co n tr a ctn d a s entered in be shared
eM p ro vi d e to Me 'Mth·
re fu : \h a •
c e provu:. . a t h a s _a m or andum o
•
:lmg o rg a 9 n f U
o p ro vi n iz a tio n pr oc es sm g in form
se M ceats·ion-sharing ar
nderstan
ding for
· t __ . ran em
~ a pu .
co n d m o b b c h e a \\ u 1e 1t w
1\\ • g •
n s p la ce h au \h or b e provtclm en\ with Im •
m es in C migration
o l)Otem . d d . 9 you W•ith Refug
ra\ sponso o n yo u r ad settlemen •
rsh· missibilit a n a a. t ees and ••
\h . y \o C if ba se
anada· d up on sennces • Citizenshi
p
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I
o e sp o n so
r in C a n a
tp g ro u
da who
p s in C a n
si g d
a d a who m
a
•
y be •
th
e results ot
yo ur Immigra
up on your

tion MedlC
arri'lal in
C anada·
A ss is ta n mterested cll E • • •
ce in n e a sp in sponso
co m p\e ti• onsorshi nng xaminatio
n g yo u r p fo r yo , n yo u have
a ) Old y a p p lic a tio n u ,and yo ur yo u {and your
o u re ce iv family, if famity. if
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