Fillable Printable Application for a Social Insurance Number Information Guider for Applicants
Fillable Printable Application for a Social Insurance Number Information Guider for Applicants
Application for a Social Insurance Number Information Guider for Applicants
NAS-2120-(01-15)
Government
of Canada
Gouvernement
du Canada
APPLICATION FOR A SOCIAL INSURANCE NUMBER
INFORMATION GUIDE FOR APPLICANTS
IMPORTANT NOTICE: This application form is not required if you apply in-person at a Service Canada point
of service
How to apply
If you reside in Canada, you should apply in-person at a Service Canada point of service.
Service Canada has made it easy and secure for you to apply for a Social Insurance Number (SIN) or to amend
your SIN record. When applying in-person, you do not have to complete an application form nor do you have
to mail your original proof-of-identity documents. Simply gather the documents you need and take them to the
nearest Service Canada point of service.
Refer to the list of documents in Step 1 to determine the original proof-of-identity documents you are required
to bring. If everything is in order, you will obtain your SIN at the time of your visit. To find the nearest
Service Canada point of service, visit our Web site at www.servicecanada.gc.ca or call 1-800-O-CANADA
(1-800-622-6232).
If this is not possible for you, there are alternate options which include having another individual submit your
application for you in-person.
All applicants residing in Canada should apply in-person; however, special measures are in place to
accommodate individuals who cannot apply in-person at a Service Canada point of service. Only individuals in
these circumstances are permitted to apply by mail:
If you live 100 km or more from the nearest Service Canada point of service, in an inaccessible area, or where
outreach is very infrequent, you may apply by mail. If you are unsure if you are eligible, visit our Web site at
Canada at 1-800-206-7218 (select option #3).
If you are unable to apply in-person at a Service Canada point of service due to other extenuating limitations
and cannot have another individual submit an application in-person on your behalf, you must contact
Service Canada at 1-800-206-7218 (select option #3) to confirm if you are eligible to apply by mail.
If you currently reside outside Canada, you are eligible to apply by mail. Follow Steps 1 to 3 to submit your
application form and provide original proof-of-identity documents to the Social Insurance Registration office.
DID YOU KNOW?
* There is no fee to apply for a Social Insurance Number (SIN).
* Original proof-of identity documents are required to apply for a SIN, photocopies are not accepted.
In-Person
By Mail
1
www.servicecanada.gc.ca to confirm your eligibility to apply by mail using your postal code or contact Service
NAS-2120-(01-15)
Step 1 - Gather the original proof-of-identity documents required
Primary proof-of-identity documents
Canadian citizens must submit one of the following original documents:
• a certificate of birth or birth certificate issued by the vital statistics agency in the province or territory
where you were born (Note: Quebec proof-of-birth documents issued prior to 1994 are not accepted);
• Certificate of Canadian Citizenship issued by Citizenship and Immigration Canada (CIC); or
• Certificate of Registration of Birth Abroad issued by CIC.
Individuals registered with Aboriginal Affairs and Northern Development Canada (AANDC), formerly
Indian and Northern Affairs Canada (INAC), need to provide the following original documents if they want
their status on the Social Insurance Register indicated as “Status Indian”:
• Born in Canada: one of the documents identified in section Canadian Citizens above and a Certificate
of Indian Status issued by INAC or AANDC; or
• Born outside Canada: birth certificate issued by a state authority from your country of birth and a
Certificate of Indian Status issued by INAC or AANDC.
Whether you apply in-person or by mail, you must provide original primary proof-of-identity documents to
prove your identity and legal status in Canada. Photocopies are not accepted. You may also need to provide
supporting proof-of-identity documents if the name indicated on your primary proof-of-identity document is
different than the name you are currently using. If you are a parent, legal guardian or legal representative
applying on behalf of the applicant, you must provide additional documents; refer to the list provided below
under Additional document(s) required for representatives.
All documents must be written in English or French or be accompanied by an official translation attested to
by the translator before a notary public, or prepared by an officer of a foreign government or an official of the
British or Canadian Consulate.
Refer to the list below to determine the proof-of-identity documents that you will need to apply.
When applying in-person, your original documents will be returned to you immediately.
Permanent Residents of Canada need to provide one of the following original documents:
• Permanent Resident Card issued by Citizenship and Immigration Canada (CIC);
• Confirmation of Permanent Residence issued by CIC, accompanied by either a travel document (for
example, a foreign passport) or an alternate photo identification issued by a provincial/territorial
authority (for example, a driver's licence).Note: The Confirmation of Permanent Residence is
acceptable if used within one year of the date you became a permanent resident. The Permanent resident
card is required after this period ;
• Record of Landing issued by CIC before June 28, 2002;
• Verification of Landing issued by CIC (only acceptable to amend a SIN record or to obtain
confirmation of an existing SIN); or
• Status Verification OR Verification of Status issued by CIC (only acceptable to amend a SIN record or
to obtain confirmation of an existing SIN).
Temporary Residents of Canada need to provide one of the following original documents:
• Work permit issued by Citizenship and Immigration Canada (CIC);
• Study permit issued by CIC . International students must present either:
• Visitor record issued by CIC, indicating you are authorized to work in Canada; or
• Diplomatic identity card and note of permission of employment issued by Foreign Affairs, Trade, and
Development Canada.
○
a study permit that indicates the permit holder “may accept employment” or “may work” in
Canada; or
○
a study permit and a “confirmation to work off campus” letter issued by CIC prior to February 6,
2015.
If neither of these requirements is met, you may contact CIC to verify if you are eligible to apply
for an amended study permit.
2
NAS-2120-(01-15)
Other - Individuals residing outside Canada who are not Canadian citizens or Registered Indians with no
legal status in Canada and are eligible to receive a Canadian government benefit or pension need to provide
both of the following original documents:
• Birth Certificate issued by a state authority from your country of birth (if not in English or French, see
beginning of Step 1) AND
• Letter confirming eligibility for pension or benefits from Canada Pension Plan (CPP), Old Age Security
(OAS) or Régie des rentes du Québec (RRQ).
Supporting proof-of-identity documents
You must also provide an original supporting proof-of-identity document if the name indicated on your
primary proof-of-identity document (see above) is different than the name you are currently using. You will
need to provide one of the following supporting proof-of-identity documents, if required:
• Certificate of marriage or a similarly titled document, depending on the issuing authority to support your
family name after marriage. Note: This does not apply to Quebec residents who were married after April
1, 1981, regardless of where they were married;
• Legal Change of Name Certificate or Court Order document issued in accordance with provincial/
territorial change of name act in Canada or similar legislation;
• Adoption order certified by a provincial/territorial court for adoptions in Canada only;
• Notarial Adoption Certificate issued by the country of origin of the child adopted abroad;
• Request to Amend Record of Landing issued by Citizenship and Immigration Canada; or
• Divorce Decree or a similarly titled document issued in accordance with a provincial/territorial court in
Canada for the dissolution of marriage. Note: Documents issued by a foreign country are not acceptable.
Additional documents required for representatives
Parent or legal guardian applying on behalf of a minor child
If you are a parent or a legal guardian applying on behalf of a minor child (i.e. child under the age of majority
in the province, territory of residence), you must provide:
• The child’s original primary proof-of-identity document as listed in Step 1 above;
• The child’s original supporting proof-of-identity document, if applicable;
• Your own original primary proof-of-identity document as listed in Step 1 above; and,
If you are a legal guardian, you must also provide an original or certified copy of a document confirming
legal guardianship issued by a provincial/territorial authority or similar legislation (in Quebec, a notarized Will
is an acceptable document).
Legal representative applying on behalf of a minor child or an adult
If you are a court appointed lawyer or individual, or provincial/territorial employee applying on behalf of a
minor child or an adult, you must provide:
• The child’s or adult’s original primary proof-of-identity document as listed in Step 1 above;
• The child’s or adult’s original supporting proof-of-identity document, if applicable;
• Your own original valid employee photo identification or government-issued identification, e.g. valid
driver’s license or passport; and,
• An original or certified copy of a document confirming proof of legal representation issued by a
provincial/territorial authority or similar legislation (in Quebec, a notarized Will is an acceptable
document).
If you are a provincial/territorial employee, you must also provide an original Letter of Authorization issued
on agency letterhead by the agency’s Director/Administrator authorizing the legal representative to represent
the agency to apply for a SIN.
REMEMBER: Photocopies are not accepted.
3
NAS-2120-(01-15)
Step 2 - Complete the Application Form
This application form is not required if you apply in-person. However, a completed and signed application
form is required if you are authorizing another individual to submit the application in-person on your behalf.
You must fully complete items #1 to #13, sign and date the application form (in blue or black ink).
Signature on the application form:
The application form must be signed by the applicant, except in the following situations:
• Child under 12 years of age: the parent or legal guardian must sign the application form.
• Child over 12 years of age and under the age of majority in their province or territory of residence:
the child, parent or legal guardian must sign the application form.
• Minor child or adult applicant who is represented by a legal guardian or legal representative: the
provincial/territorial employee, the legal guardian, or the court appointed lawyer or individual must sign
the application form.
If “X” is used as a signature, two witnesses must sign in the signature portion and indicate their relationship to
you on the application form.
IMPORTANT: If you are a mother, father, legal guardian or legal representative, check the appropriate box on
the form to indicate your relationship to the applicant and print and sign your name (Section 13).
Failure to fully complete, sign and date the application form will result in your application not being accepted.
If you are eligible to apply by mail, you can mail an application form with original proof-of-identity
documents. Service Canada is not responsible for documents lost in the mail. You should protect your personal
information by sending your documents in a secure manner (for example by using a postal service with
tracking). Photocopies are not acceptable. Refer to the How to Apply section to ensure you are eligible to
apply by mail. If your application and documents are in order, you will receive your SIN in the mail within 20
business days. Failure to provide the necessary documents will result in your application not being accepted.
Step 3 - Mail the application and original documents
Mail the completed, signed application form and all required original proof-of-identity documents to:
Service Canada
Social Insurance Registration Office
P.O. Box 7000
Bathurst, NB E2A 4T1
Canada
Note: Prior to mailing your application, refer to the Social Insurance Number Application –Checklist for
Applicants Eligible to Apply by Mail to ensure your application is complete. An application that is incomplete,
unsigned or missing original proof-of-identity documents will not be accepted.
FOR MORE INFORMATION
CALL 1-800-206-7218 (Select option “3”). Agents are available Monday to Friday, 8:30 am to 4:30 pm
Canadian Local Time, except on statutory holidays. If you have a hearing or speech impairment and use a
teletypewriter (TTY), call 1-800-926-9105. If you are calling from outside Canada, the number is
506-548-7961 (long distance charges apply) from 8:00 am to 8:30 pm (Atlantic Standard Time).
VISIT a Service Canada Centre. You can find the Centre nearest you by visiting our Web site or by calling
1-800-O-Canada (1-800-622-6232).
4
CLICK our Web site at servicecanada.gc.ca.
NAS-2120-(01-15)
SOCIAL INSURANCE NUMBER APPLICATION
PROTECTED WHEN COMPLETED - B
FINDER NO DATE
DO NOT WRITE IN THIS AREA
I am applying for a (an):
FIRST SOCIAL INSURANCE NUMBER (SIN)
UPDATE or CORRECTION TO SIN RECORD
CONFIRMATION OF SIN
LEGAL CHANGE OF NAME
CHANGE OF STATUS
CHANGE TO THE EXPIRY DATE (“900 Series SIN”)
OTHER - SPECIFY
INFORMATION CONCERNING THE APPLICANT PRINT CLEARLY IN BLUE OR BLACK INK
APPLICANT’S NAME
TO BE SHOWN ON
SIN RECORD
First Given Name Other Given Name(s) Family Name
2
APPLICANT’S
DATE OF BIRTH
Day Month Year
3
APPLICANT’S
SEX
Male
Female
Check if the applicant is a twin, triplet, etc.
4
APPLICANT’S
MOTHER'S NAME
AT HER BIRTH
Given Name(s) Family Name at Birth
5
APPLICANT’S
FATHER'S NAME
AT HIS BIRTH
Given Name(s) Family Name at birth
6
APPLICANT'S
PLACE OF BIRTH
City, Town or Village Province/Territory/State Country
7
APPLICANT’S FAMILY NAME AT BIRTH
9
DID THE APPLICANT EVER HAVE A SOCIAL INSURANCE NUMBER (SIN)?
Unknown (don’t recall)No
10
APPLICANT’S
STATUS IN
CANADA
Check one of the following:
IS THE APPLICANT currently residing in Canada?
11
Daytime Telephone Number Evening Telephone Number
12
APPLICANT’S
MAILING ADDRESS
Province/Territory/State Country
In care of (if different than the name in item 1)
Number and Street Apartment, suite or unit No.
City, Town or Village Postal/ZIP Code
13
The personal information you provide is collected for the administration of the Employment Insurance Act (EIA) and the Department of Employment and Social Development Act (DESDA). It
will be used by Service Canada officials (operating within Employment and Social Development (ESD)) for the purpose of assigning a Social Insurance Number (SIN) to you or your child, as
authorized by the DESDA. Your personal information is administered in accordance with the DESDA, the EIA and the Privacy Act and your information will be retained in the Social Insurance
Register. Participation is voluntary. However refusal to provide your personal information will result in you or your child not receiving a SIN. The information you provide may be shared with
federal departments and agencies that are authorized users of the SIN and in accordance with the Treasury Board Secretariat Directive on the Social Insurance Number for the administration
of benefits and services. The information may also be shared with provincial departments and agencies for the administration of benefits and services and/or federal and provincial departments
for the administration and enforcement of the legislation for which they are responsible. The information and documents you provide may also be verified with provincial and territorial vital
statistics registers or Citizenship and Immigration Canada records. The information may also be used and/or disclosed for policy analysis, research and/or evaluation purposes, and may be
linked to various sources of information under the custody and control of ESD. However, these additional uses and/or disclosures of your personal information will not result in an administrative
decision being made about you. You have the right to the protection of and access to your personal information, which is described in Personal Information Bank (HRSDC PPU 390) of the
government publication Info Source. Instructions for obtaining this information are outlined in Info Source, which is available online at infosource.gc.ca. Info Source may also be accessed
online at any Service Canada Centre.
Signature of applicant/representative:
Date :
IT IS AN OFFENCE TO FRAUDULENTLY USE YOUR SIN, INCLUDING TO KNOWINGLY APPLY FOR MORE THAN ONE SIN AND TO SELL, GIVE OR LEND YOUR
NUMBER OR CARD TO ANYONE WITH THE INTENT TO DECEIVE.
DO NOT WRITE BELOW - FOR OFFICE USE ONLY
A
ALL NAMES
AS SHOWN ON
PRIMARY DOC.
Given Names Family Name
B
DATE OF BIRTH
AS SHOWN ON
PRIMARY DOC.
Day Month Year
C
PRIMARY
DOCUMENT
SEEN
Abbreviation
D
DOCUMENT NO.
E
SUPPORTING
DOCUMENT
SEEN
Abbreviation
F
USER CODE:
G
SECONDARY DOCUMENT SEEN
H
REMARKS / REASON FOR PRIORITY REQUEST
RESPONSIBILITY CENTRE NO. WHERE REFERRAL GENERATED: REFERENCE (FINDER) NO.: OFFICER’S INITIALS:
Printed Name of representative: Telephone Number of representative:
This application form is not required if you go in-person to apply. Refer to the Information Guide or call
1-800-206-7218 (select Option #3) or 506-548-7961 (long-distance charges apply) to determine if you are eligible
to apply by mail.
This application form must be accompanied by original document(s).
Gouvernement
du Canada
Government
of Canada
1
Canadian
Citizen
Registered
Indian
Permanent
Resident
Temporary
Resident
Other
Yes No
OTHER FAMILY NAME(S) PREVIOUSLY USED
8
IMPORTANT: If you are a representative such as a parent, legal guardian or legal representative applying on behalf of the applicant you must sign for the applicant and provide additional
document(s). Refer to the Information Guide for Applicants -Additional document(s) required for representatives.
I acknowledge that the information provided on the application form is true and complete.
Relationship of representative to the applicant:
Mother Father Legal Guardian Legal Representative
If yes, write the nine digit number here
- -
Abbreviation
NAS-2120-(01-15)
IMPORTANT: Review the following requirements. Failure to provide the necessary information, (completed
application and original proof-of-identity documents) will result in your application being returned. You will
receive a response within 20 business days from the date your request is received.
not live in a remote area or to submit an application on behalf of someone else.
Did you include:
• The original primary proof-of-identity document in order to prove the identity and legal
status in Canada of the applicant?
• The original supporting proof-of-identity document if the name indicated on the
applicant’s primary identity document is different from the name now being used?
• The completed, signed and dated Social Insurance Number application form?
• The relationship to the applicant in Item 13, if applicable?
• The mailing address of the Social Insurance Registration Office indicated properly?
Service Canada
Social Insurance Registration Office
P.O. Box 7000
Bathurst, NB E2A 4T1
Canada
For more information:
If you are applying on behalf of someone else, did you also include:
• Your own original primary proof-of-identity document if you are a parent or legal
guardian applying on behalf of your minor child?
• Your own original valid government-issued identification if you are a legal representative
applying on behalf of a minor child or an adult? Note: for provincial/territorial employees, an
original valid employee identification is accepted.
• The original letter of authorization issued on agency letterhead and signed by the agency’s
Director/Administrator authorizing you as a legal representative to apply on behalf of a minor
child or an adult if you are a provincial/territorial employee?
• The original document or certified copy confirming legal guardianship or legal representation
if you are a legal guardian or legal representative of the applicant?
Social Insurance Number Application
Checklist for Applicants Eligible to Apply by Mail
NOTE: There is no fee to apply for a Social Insurance Number.
FOR APPLICANTS RESIDING IN CANADA: Visit our Web site at www.servicecanada.gc.ca to confirm
your eligibility to apply by mail by using your postal code. Call 1-800-206-7218 (select Option “3”) if you do
Visit servicecanada.gc.ca
