Sponsorship Undertaking Form - Canada

Citizenship and
Immigration Canada
Citoyenneté et
Immigration Canada
PAGE 1 OF 5
IMM 5373PP (12-2012) E
PROTECTED WHEN COMPLETED -
B
This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants.
(AUSSI DISPONIBLE EN FRANÇAIS - IMM 5373PP F)
UNDERTAKING/APPLICATION TO SPONSOR
UNDERTAKING TO SPONSOR UNDER A PUBLIC POLICY
Settlement Organization (SO) Group of Five (G5)
Check the appropriate box below. I am / We are a:
If you require more space to provide all the necessary information, attach a separate sheet with further details. Print the sponsor's name at the top of
each additional sheet and indicate the form's title and the number of the question you are answering.
FOR CIC USE ONLY
CIC File Identification No.
Principal Applicant ID No.
Name of Principal Applicant
Home telephone no.
Name of Sponsorship Group (SO/G5)
Year DayMonth
Date
of birth
Name of representative - Surname Given name(s)
Other names used (include birth name, maiden, previous married name, aliases and nicknames)
Address Apt./Unit City Province Postal code
No.Area code
Work or cell telephone no.
No.Area code Ext.
E-mail address
FOR CIC USE ONLY
Group ID no.
Home telephone no.
Name of corporation (if applicable)
Year DayMonth
Date
of birth
B - THIS SECTION MUST BE COMPLETED BY CO-SPONSORS (INDIVIDUAL OR GROUP) ONLY
Name of representative - Surname Given name(s)
Other names used (include birth name, maiden, previous married name, aliases and nicknames)
Address Apt./Unit City Province Postal code
No.Area code
Work or cell telephone no.
No.Area code Ext.
E-mail address
Relationship to principal applicant (if applicable)
FOR CIC USE ONLY
Group ID no.
A - SPONSORSHIP GROUP - THIS SECTION MUST BE COMPLETED BY ALL SPONSORING GROUPS
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