Application for a Permanent Resident Card - Canada

Citizenship and
Immigration Canada
Citoyenneté et
Immigration Canada
PAGE 1 OF 5
IMM 5444 (02-2015) E
PROTECTED WHEN COMPLETED -
B
APPLICATION FOR A PERMANENT RESIDENT CARD
(DISPONIBLE EN FRANÇAIS - IMM 5444 F)
This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants.
Confused by a question? See step 2 of the instruction guide.
TYPE or PRINT in black or blue ink
1. Language you prefer for correspondence
English French
2. Date you became a permanent resident of Canada
(YYYY-MM-DD)
3. You are applying to (check one box)
Obtain your first
Permanent Resident Card
Renew your present
Permanent Resident Card
Replace a lost, stolen, destroyed or never
received Permanent Resident Card
NOTE: If you are applying to renew your present card, you should keep it until you receive your replacement card. You will be asked to destroy your old card when you receive your
new one. If you are applying to replace your damaged card, you must send the damaged card with your application.
A. PERSONAL DETAILS
4. Your full name as shown on your Record of Landing (IMM 1000), Confirmation of Permanent Residence (IMM 5292) or (IMM 5688), or last Permanent Resident Card (include a
photocopy of your last Permanent Resident Card).
Family name (surname) Given name(s)
5. Your current name, if different from above
(Note: you must provide supporting documents for any change in your name. Consult "Step 1. Gather documents" in the instruction guide
Family name (surname) Given name(s)
6. Your sex
Male Female
7. Your date of birth
(YYYY-MM-DD)
8. Your country of birth
9. Your country or countries of citizenship
10. Colour of your eyes
Blue Grey Brown Green Black Hazel (yellowish brown) Other
11. Your height
cm
or
ft in
12. Your current residential address in Canada
Apartment Street no. Street name
City
Province
Postal code
13. Your mailing address in Canada (if different from above)
Apartment Street no. Street name
City
Province
Postal code
All correspondence will go to this address unless you indicate your e-mail address below. Indicating an e-mail address will authorize all correspondence, including file and personal
information, to be sent to the e-mail address you specify.
14. Your telephone numbers and e-mail address
At home Alternative E-mail
15. Your current marital status
Never married Married Widowed Legally separated Divorced Common-law
B. YOUR IMMIGRATION HISTORY
16. Place you became a permanent resident of Canada
City/Port of entry Province
17. Have you ever been issued a removal order in Canada?
Yes No
18. Has an Immigration Officer ever issued you a Report Under subsection 44(1) or made the decision
that you have not met the residency obligations required of Canadian permanent residents?
Yes No
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