Child Under 16 Travel Document Application - Canada

Child's Personal Information
Surname and given name(s) to appear in travel document
Write the child's name to appear in the travel document. This name is normally the same as the surname (last name) and given name(s)
shown on the child's proof of immigration status. If you are requesting a travel document in a name that is different from the name that
appears on the child's immigration status document, one (1) of the following documents will be required to confirm the child's change of
A legal change of name order
An adoption order
Proof that the record of entry at Citizenship and Immigration Canada has been amended, i.e. approved "Request to Amend the
Record of Landing (IMM 1000), Confirmation of Permanent Residence (IMM 5292 or IMM 5688) or Valid Temporary Resident
Documents" (IMM 1436).
Surname (last name) at birth and former surname (last name)
Complete if different from the surname (last name) to appear in the travel document (for Passport Program, Citizenship and Immigration
Canada information only—it will not appear in the travel document).
Date of birth
The date of birth will be inscribed in the travel document exactly as it appears on the proof of immigration status unless Citizenship and
Immigration Canada records have been amended subsequent to the child's admission to Canada. In this case, the original approved
"Request to Amend the Record of Landing (IMM 1000), Confirmation of Permanent Residence (IMM 5292 or IMM 5688) or Valid
Temporary Resident Documents" (IMM 1436) is required. If the child's proof of immigration status does not show a complete date of birth,
the specific year, month and day of the child's birth will be entered as shown on the child’s supporting documents.
Provide original or copies signed and dated by your guarantor of any supporting identification showing that date of birth.
Children 11 years of age or over must sign
their usual signature.
Note: At no time should a person other than the child sign in this signature box, section 1, without exception.
Who May Apply for a Travel Document for a Child?
One of the parents
The custodial parent in cases of separation or divorce
The legal guardian
Information on Applicant and Proof of Parentage
Both parents are requested to participate in obtaining a travel document for their child and to sign the application form. The other
parent may be contacted. If you do not know the whereabouts of the other parent, please contact us. When a legal guardian is the
applicant, the other legal guardian(s), as the case may be, must also participate. Proof of legal guardianship is required.
Proof of parentage between the child and the parent(s)
You must submit one of the following acceptable proof of parentage documents demonstrating the relationship between the child and the
A detailed birth certificate from the child's country of birth indicating the name of the parent(s); or
An order of adoption indicating the name of the adopting parent(s)
Exception: An application submitted for a child will only be accepted without proof of parentage if:
a Canadian certificate of identity or Canadian travel document was previously issued to the child in his or her name; and
the parents or legal guardians who participated in the previous application are the same ones participating in this application.
Custody, separation or divorce
When a court order or agreement exists referring to custody of the child, only the person with custodial rights may apply. All documents
that refer to custody of, mobility of, or access to the child must be provided. If a divorce has been granted, a copy of the divorce judgment
or order must also be provided. When joint custody provisions exist, either parent may be the applicant.
Relationship with other parent
Indicate your current relationship with the other parent: single (no relationship), common law, married, separated, divorced, widowed.
Indicate date of marriage to the other parent, if applicable. Additional information or documentation may be requested.
When a legal guardian is the applicant, proof or legal guardianship must be provided.
Deceased parent
If the other parent is deceased, the applicant must enclose a death certificate with the application. When completing section 2 of the form,
the applicant must provide as much information as possible.
Proof of Immigration Status in Canada
Provide one (1) of the valid immigration status documents listed in section 3 on the application form (original only). It will be returned to
you. Additional information may be requested to confirm the child's immigration status in Canada. If you require an immigration status
document, contact Citizenship and Immigration Canada (see section F).
- Page 7 of 10
PPTC 192 (2015-05) R1
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