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Fillable Printable Child Abroad General Passport Application for Canadians Under 16

Fillable Printable Child Abroad General Passport Application for Canadians Under 16

Child Abroad General Passport Application for Canadians Under 16

Child Abroad General Passport Application for Canadians Under 16

Child Abroad General Passport Application
for Canadians under 16 years of age applying outside of Canada
Protected B when completed
Warning—Any false or misleading statement with respect to this application and any supporting document, including the concealment of any material fact, may
result in the refusal to issue a passport, the revocation of a currently valid passport, or the refusal of passport services, and may be grounds for criminal
prosecution. Your application will not be processed if you fail to complete all of the required sections of this form and/or refuse to consent to the exchange or
disclosure of any personal information required for the delivery of passport services.
Type or print in CAPITAL LETTERS using black or dark blue ink.
Child's Personal Information (see Instructions, section H)
1
Surname (last name)
Given name(s)
Surname (last name) at birth
Former surname (last name)
Date of birth
Year
Month Day
Place of birth
City Country Prov./Terr./State (if applicable)
Sex
Female
Male
Eye colour Current hair colour Height
(cm/in)
Weight
(kg/lbs)
Current home address
Number Street Apartment City
Country
Postal code
Mailing address (if different from above)
Number
Street Apartment City
Country
Postal code
Children 11 years of age or over must sign in this signature box.
Note: At no time should a person other than the child sign in this
signature box, without exception.
Date
Year
Month Day
Signed at
City
Country
Sign within border
Signature of child (see Instructions, section H)
Date of travel
Unknown
Month Day
Information on Applicant (see Instructions, section J)
2
Is the child currently the subject of an adoption process or partially or fully in
the care of a family services organization?
No Yes
Are there any separation agreements, court orders or legal proceedings
pertaining to custody of, mobility of, or access to the child?
No Yes
If yes, include all documents
Relationship between the applicant (parent or legal guardian) and the other parent or legal guardian
Date of marriage (if applicable)
Year
Month Day
Applicant (parent or legal guardian)
Surname (last name) at your birth
Given name(s)
Date of birth
Year
Month Day
Country of birth
Address
Telephone (daytime) Telephone (other)
Email address (optional)
Declaration—I declare that the child named above is a Canadian citizen, that I am the
parent or legal guardian of this child and that the statements made in this application are
true. I declare that I have read and understood the Warning at the top of this page and the
Privacy Notice Statement (see section P). I consent to the collection, use and disclosure of
my personal information and that of the child by Passport Program, Citizenship and
Immigration Canada, other federal government institutions, Government of Canada offices
abroad and third party entities as outlined in the Privacy Notice Statement in the
Instructions.
Signature of applicant (also sign section 5) Date Signed at
Other parent or legal guardian
Surname (last name) at your birth
Given name(s)
Date of birth
Year
Month Day
Country of birth
Address
Telephone (daytime) Telephone (other)
Email address (optional)
Declaration—I declare that the child named above is a Canadian citizen, that I am the
parent or legal guardian of this child and that the statements made in this application are
true. I declare that I have read and understood the Warning at the top of this page and the
Privacy Notice Statement (see section P). I consent to the collection, use and disclosure of
my personal information and that of the child by Passport Program, Citizenship and
Immigration Canada, other federal government institutions, Government of Canada offices
abroad and third party entities as outlined in the Privacy Notice Statement in the
Instructions.
Signature of other parent or legal guardian
Date Signed at
Aussi accessible en français
- Page 1 of 8
(Number, Street, Apartment, City, Country, Postal code)
(Number, Street, Apartment, City, Country, Postal code)
PPTC 042 (2015-05) R1
Previous Canadian Travel Document (see Instructions, section K)
3
Has a Canadian travel document (passport, certificate of identity or refugee travel document) been issued to the child?
No
Yes (specify)
Number
Date of issue
Year
Month Day
If the passport is still valid, include it with your application.
Would you like the previous passport returned to you? If not, it will be securely destroyed by Passport Program to protect the child's
personal information.
Yes, please return the previous passport to me.
Note: If a valid Canadian travel document has been lost, stolen, damaged or is inaccessible, complete form PPTC 203, Declaration,
available online at passportcanada.gc.ca. A Canadian travel document, once reported lost or stolen, is no longer valid. There is
an administrative fee for the replacement of a valid lost or stolen Canadian travel document (see section D).
Proof of Canadian Citizenship (see Instructions, sections J and L)
4
Provide one (1) of the documents listed below (original only):
(to be completed if the child was born in Canada)
Birth certificate in Canada
Certificate of Canadian citizenship
Registration number Date of issue
Certificate number Date of issue/Effective date of citizenship
Declaration of Applicant
5
Surname (last name) of applicant
Given name(s) of applicant
Relationship to the child Surname (last name) of child Given name(s) of child
Declaration—I solemnly declare that the child named above is a Canadian citizen, that the photos enclosed are unaltered and a true likeness of the child, that all of the statements made and the information
provided in this application, as well as any supporting documents, are true. I declare that I have read and understood the Warning on page 1 and the Privacy Notice Statement (see section P). I consent to the
collection, use and disclosure of my personal information and the child by Passport Program, Citizenship and Immigration Canada, other federal government institutions, Government of Canada offices abroad
and third party entities as outlined in the Privacy Notice Statement in the Instructions.
Signature of applicant Date
Year
Month Day
Signed at
City Country
Declaration of Guarantor (see Instructions, section M-A Passport holder or section M-B Occupation)
The guarantor must know the applicant identified in section 5.
6
Surname (last name) Given name(s)
Canadian passport number (see section M-A) or Occupation (see section M-B) Telephone (daytime)
Date of birth in passport (see section M-A) or Name of firm/organization (see section M-B)
Year Month Day
Telephone (other)
Current home address (see section M-A) or Business address (see section M-B)
Number Street City
Country
Full name of applicant parent or legal guardian Full name of child
I have known
the applicant
(parent or legal
guardian) for
Number of years
Declaration—I solemnly declare that I have known the applicant identified above personally for at least two (2) years and have knowledge of the child. I have signed the back of one (1)
photo to certify that the image is a true likeness of the child. I declare that I have read and understood the Warning on page 1 and the Privacy Notice Statement (see section P). I consent
to the collection, use and disclosure of my personal information by Passport Program, Citizenship and Immigration Canada, other federal government institutions, Government of Canada
offices abroad and third party entities as outlined in the Privacy Notice Statement in the Instructions.
Signature of guarantor Date
Year
Month Day
Signed at
City
Country
Emergency Contact Information (optional)
(see Instructions, section N)
7
Surname (last name) Given name(s)
Relationship to the child Telephone (daytime) Telephone (other) Cell number
Current home address
Number
Street Apartment City
Country
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PPTC 042 (2015-05) R1
Child Abroad General Passport Application
for Canadians under 16 years of age applying outside of Canada
Instructions
Entitlement to a Canadian Passport
A
Important notice—We recommend that you not finalize your travel plans until you receive the requested passport.
A Canadian passport is the only reliable and universally accepted travel and identification document for Canadians who travel abroad.
Canadian passports are issued to Canadian citizens only.
For Canadians 16 years of age or over, use form PPTC 040, Adult Abroad General Passport Application.
Translation
B
All documents submitted throughout the passport application process that are in a language other than English or French must be
translated by a certified translator.
Requirements Checklist
C
Both pages of the application form completed and signed within the last twelve (12) months
Two (2) identical unaltered passport photos of the child taken within the last six (6) months
Application form and one of the photos certified by your guarantor
Proof of Canadian citizenship (original only—the document will be returned to you)
Any valid Canadian travel document (passport, certificate of identity or refugee travel document) issued to the child
Acceptable proof of parentage
All documents (including any divorce judgment) that refer to custody of, mobility of, or access to the child
The fee
Additional documents or information may be requested in support of this application.
Fee and Period of Validity
D
Where the application is made outside Canada or the passport is to be delivered outside Canada:
5-year validity – Can$100
The fee is in Canadian funds and should be converted to local funds. Please confirm fee and accepted methods of payment with the
nearest Government of Canada office abroad.
There is a separate, non-refundable Can$45 administrative fee for the replacement of a valid lost or stolen Canadian travel document.
Methods of payment
Cash (where accepted).
Debit card (Interac), Visa Debit, Virtual Visa Debit or other
prepaid cards (Visa, MasterCard) only for in-person applications
submitted by the cardholder (where accepted).
Prepaid debit cards are not accepted.
Credit card (where accepted).
Certified cheque or international money order (postal or bank) in
the exact amount, payable to the Canadian Embassy, High
Commission or Consulate, as the case may be (where
accepted).
Important
Every person who requests passport services must pay the
applicable fee in the exact amount.
Applicants who cancel their application or are refused a passport
are not eligible for a refund of the passport service fee.
Administrative fees and applicable interest will be applied to all
dishonoured payments.
Fees are subject to change.
Credit Card Information (where accepted)
E
Payment by credit card for passport services at a Government of Canada office abroad requires the completion of a separate credit card
authorization form. By completing and signing the authorization form, you are providing formal authorization to charge your credit card for
payment of the services requested. The form must be included with your passport application.
Important notice: There is a fee to use the credit card payment service, a payment solution developed by Foreign Affairs, Trade and
Development Canada. This fee is separate and independent from the amount payable to the Government of Canada for any passport
service.
For more information and to access the credit card authorization form online, visit the Government of Canada website at travel.gc.ca.
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PPTC 042 (2015-05) R1
Where to Apply
F
Submit the child's application at the nearest Government of Canada office that provides passport services in the country where you
reside or are visiting. A list of Government of Canada offices abroad is available online at travel.gc.ca or consult your local telephone
directory.
Offices authorized to process passport applications include:
Canadian embassies
Canadian high commissions
Canadian consulates (except those headed by honorary consuls)
Contact Information
G
General information is available 24 hours a day, 7 days a week. Specific information is available at the nearest Government of Canada
office that provides passport services (consult your local telephone directory).
Information on passports, fees and processing times
Website passportcanada.gc.ca
Passport Program 819-997-8338
TTY (for persons who are Deaf or hard of hearing)
Montréal, Canada
514-283-5197
Travel reports, warnings and requirements
Website
travel.gc.ca
Application forms are available in large print.
A passport application instruction booklet is available in Braille.
Child's Personal Information
H
Surname and given name(s) to appear in passport
Write the child's name to appear in the passport. The name must not differ from the name that appears on the child's documentary
evidence of citizenship.
Additional documents may be requested to verify the child's identity.
Surname (last name) at birth and former surname (last name)
Complete if different from the surname (last name) to appear in the passport (for Passport Program, Citizenship and Immigration Canada
information only—it will not appear in the passport).
Date of birth
If the child's proof of citizenship 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.
Place of birth
The child's place of birth must be provided on the application form. If you do not wish the child's place of birth to appear in the passport,
submit form PPTC 077, Request for a Canadian passport without place of birth, available online at passportcanada.gc.ca.
Signature
Children 11 years of age and 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.
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PPTC 042 (2015-05) R1
Who May Apply for a Passport for a Child?
I
One of the parents
The custodial parent in cases of separation or divorce
The legal guardian
Information on Applicant and Proof of Parentage
J
Both parents are requested to participate in obtaining passport services 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 provide one of the following acceptable proof of parentage documents demonstrating the relationship between the child and the
parent(s):
A detailed birth certificate from Canada (also serves as proof of citizenship) or from a foreign country where the child was born,
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 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 of legal guardianship must be provided.
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.
Deceased parent
Previous Canadian Travel Document
K
Enclose any valid Canadian travel document (passport, certificate of identity or refugee travel document) issued to the child. If the
passport is valid for more than twelve (12) months from the date the application is submitted, provide a written explanation as to why
you are applying at this time. Should Passport Program, Citizenship and Immigration Canada not be satisfied that you have a valid
reason for applying early, your application for a new passport may be refused.
A person's name may appear in only one (1) valid Canadian travel document.
Note: If a valid Canadian travel document has been lost, stolen, damaged or is inaccessible, complete form PPTC 203, Declaration,
available online at passportcanada.gc.ca. A Canadian travel document, once reported lost or stolen, is no longer valid. If found, it
must not be used for travel and must be returned immediately to Passport Program or if abroad to the nearest Government of Canada
office. There is an administrative fee for the replacement of a valid lost or stolen Canadian travel document (see section D).
Proof of Canadian Citizenship
L
Provide one (1) of the documents indicated in section 4 on the application form (original only). It will be returned to you. Additional
information may be requested to confirm the child's citizenship.
Certificate of birth in Canada
Only official birth documents issued by the vital statistics office for the child's province or territory of birth in Canada are accepted. This
includes detailed birth certificates indicating the name of the parent(s) which can also be used as proof of parentage (see section J).
Certain exceptions may apply. More information is available online at passportcanada.gc.ca.
Certificate of Canadian citizenship
Commemorative documents of citizenship are not accepted. If the child requires a certificate of Canadian citizenship, contact the nearest
Government of Canada office. You may also visit the Citizenship and Immigration Canada website at cic.gc.ca.
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PPTC 042 (2015-05) R1
Declaration of Guarantor
M
A guarantor is a person other than the applicant who confirms the applicant's identity and has knowledge of the child. The other parent,
legal guardian, family member or a person who resides at the same address as the applicant may be the guarantor, provided that the
individual meets the specified requirements.
The guarantor must:
have known you (the applicant) personally for at least two (2) years*. To know an applicant personally means that the guarantor is able
to confirm aspects of the applicant's personal attributes;
perform the following two (2) tasks free of charge:
1. Complete and sign the Declaration of Guarantor (section 6) (ensure you have completed and signed both pages of the
application before submitting it to your guarantor).
2. Write "I certify this to be a true likeness of (child's name)" on the back of one (1) of the child's photos, and signed it;
know you well enough to be confident that the statements you have made on the application form are true;
be accessible to the Passport Program for verification; Passport Program reserves the right to request a new guarantor.
The applicant must not assist the guarantor in performing his or her duties. If your guarantor requires assistance, contact Passport
Program.
The guarantor can be either a Canadian passport holder (see section M-A below) or a member of an eligible occupation (see
section M-B below).
Section M-A: Canadian passport holder
The guarantor must:
be a Canadian citizen, 18 years of age or over;
hold a 5-year or a 10-year Canadian passport that is valid or has expired within the last year from the date we receive this application;
have been 16 years of age or over when the application was submitted for the passport identified in section 6 on this application form;
and
provide the requested information contained in the passport issued in his or her name by completing, by hand, the declaration of
guarantor section of the application form.
A Canadian passport holder guarantor does not need to reside in the same country as the applicant.
OR
Section M-B: Occupation
The guarantor must:
currently work and/or reside within the area of accreditation served by the Government of Canada office abroad where the
application is submitted; and
be currently registered/licensed with the appropriate local authority to practice one (1) of the following professions:
Dentist
Medical doctor
Dean or head of university or college
Judge
Lawyer or notary
Notary public
Pharmacist
Veterinarian
Police officer
Signing officer of a bank or trust company, or of a financial institution that offers a
full range of banking services (cash withdrawals, deposits, savings)
The above list is not a recognition or endorsement by Passport Program of professional status or superior qualifications.
A guarantor from the eligible list of occupations does not need to be a Canadian citizen.
If you have not known an eligible guarantor from either section M-A, Canadian passport holder, or section M-B, Occupation, for at
least two (2) years, complete form PPTC 132, Statutory Declaration in Lieu of Guarantor, available at any Government of Canada office
that provides passport services. The form must be completed at your expense before a person who is authorized by law to administer an
oath or solemn affirmation. This may delay the processing time of the passport.
Emergency Contact Information
N
We recommend that you provide the name of someone who would not normally travel with the child. This information is
helpful if the child has an accident or becomes ill while travelling.
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PPTC 042 (2015-05) R1
Child Abroad General Passport Application
for Canadians under 16 years of age applying outside of Canada
Canadian Passport Photo Instructions
O
You must submit two (2) identical unaltered photos with each passport application. Digital (electronic format) photos are unacceptable.
The photos must:
be taken by a commercial photographer;
be clear, sharp and in focus. Photos may be in colour or in black and
white;
have a neutral facial expression (eyes open and clearly visible,
mouth closed, no smiling);
have uniform lighting—no shadows, glare or flash reflections;
be taken straight on with the face and shoulders centred and
squared to the camera;
be taken in front of a plain white or light-coloured background to
clearly distinguish the person from the background. Photos must
reflect or represent natural skin tones;
be originals that have not been altered in any way or taken from an
existing photo;
reflect the current appearance of the child (taken within the last
six (6) months); and
be professionally printed on plain, high-quality photographic paper
(photos printed at home and photos printed on heavy-weight paper
are not acceptable).
Frame Height 70 mm (2 3/4 in.)
Minimum Face Height
31 mm (1 1/4 in.)
Maximum Face Height
36 mm (1 7/16 in.)
Frame Width 50 mm (2 in.)
Photo Co. Ltd.
111 Any Street
Any Town, COUNTRY
Photo taken
Date
I certify this to be a
true likeness of
(child's name)
Guarantor's Signature
Not actual size. Refer to measurements above.
The following must appear on the back of one photo
The name and complete address of the photo studio (not a P.O. Box) and the date the photo was taken. The photographer may use a
stamp or handwrite the information (stick-on labels are not acceptable).
The guarantor's signature.
Additional information
Prescription glasses may be worn in photos as long as there is no glare and the eyes are clearly visible. The red-eye effect, tinted
glasses and sunglasses make the photos unacceptable.
Hats and head coverings must not be worn, except for religious beliefs or medical reasons. However, the head covering must not cast
shadows on the face and the full face must be clearly visible.
Child photos
The above instructions apply equally to photos of children.
The photo must show the child's head and shoulders only. The hands of the parent or the child must not appear in the photo.
Passport Program, Citizenship and Immigration Canada recognizes that it is difficult to obtain a neutral expression from a newborn and
will be tolerant in this respect.
For newborn babies, the photo may be taken while the child is sitting in a car seat, as long as a white blanket is placed over the seat
behind the child's head. There must be no shadows on the face or shoulders, around the ears or in the background.
More information is available at passportcanada.gc.ca.
Privacy Notice Statement
P
All personal information provided on this application form is collected by Passport Program, Citizenship and Immigration Canada (CIC)
for the purpose of determining entitlement of the child to a Canadian passport and to provide information to the Consular Operations
Bureau of Foreign Affairs, Trade and Development Canada in the event that the passport holder requires assistance while travelling
abroad. In the performance of those services, personal information is collected, used and disclosed under the authority of the Canadian
Passport Order and in accordance with the Privacy Act and any other federal laws, regulations and policies applicable to the protection of
personal information, as described in Personal Information Bank PPTC PPD 102 (Regular and Official Travel Passports). In the context
of the delivery of passport services, CIC and other federal government institutions or Government of Canada offices abroad assisting in
the delivery of passport services may exchange personal information. In addition, in determining current and ongoing entitlement and to
maintain the integrity of the Passport Program, all personal information collected is subject to verification and security queries to
authenticate identity and citizenship, as well as to identify the existence of grounds for refusal to issue a passport, the revocation of a
currently valid passport or the refusal of passport services. In the same context, the guarantor's personal information is also subject to
verification and security queries to determine whether the individual meets the guarantor requirements. Personal information may be
disclosed to third party entities, such as law enforcement authorities and identity document issuing institutions, for verification and
security queries required in the delivery of passport services. Personal information may also be disclosed by third party entities to CIC or
other federal government institutions or Government of Canada offices abroad for those same purposes. To strengthen the security of the
Canadian passport, CIC uses facial recognition technology. Also, an electronic chip is inserted into the booklet. The chip contains, in
electronic format, the photo of the bearer and the personal information found on page 2 of the booklet.
CIC may contact the applicant/passport holder to solicit feedback about passport services.
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PPTC 042 (2015-05) R1
Important information concerning children travelling abroad
For more information, visit international.gc.ca and travel.gc.ca/child.
Travelling with Children or Children Travelling Alone
Q
Immigration authorities in most countries are increasingly vigilant when children cross international borders. Whether travelling
alone or accompanied by an adult, each child travelling abroad must have an individual valid passport and may also require
supporting documentation. Prior to any travel, you should contact the embassy or consulate of all countries the child will be
visiting to inquire about entry requirements.
Documentation to Facilitate Travel Abroad
R
The following documents may be requested to support the entry of a child to another country:
Birth certificate showing the names of both parents.
Documents pertaining to custody.
A letter of consent authorizing the child to travel alone; with only one parent; or with someone other than the custodian or
guardian, as the case may be. The child should have a letter from every person or organization with custodial rights,
guardianship rights or, in Quebec only, parental authority. Foreign Affairs, Trade and Development Canada recommends that
the letter be certified, stamped, or sealed by an official with the authority to administer an oath or solemn declaration.
If one of the parents is deceased, the death certificate.
Documentation and Tips to Facilitate the Return to Canada
S
The following tips may help to avoid delays when a child is returning to Canada:
Make sure you carry proper identification for yourself and any children travelling with you to assist in confirming your legal
right or authorization to enter Canada upon your return.
If you have custody of the child, carry copies of documents that specify your custody rights.
If you are not the legal guardian of the child, carry a letter of permission or authorization giving you custody when entering
Canada. When one parent is travelling with a child, a letter from the other parent can also facilitate the return of both the
parent and the child. The letter should also contain telephone numbers where the parents or legal guardians can be
contacted.
If you are travelling with a group, make sure you are in the same vehicle as the child you are accompanying when arriving at
a border crossing.
Have the child memorize a telephone number to call in case of emergency.
Custody Information
T
Custody arrangements in Canada may not be recognized in another country. In extreme cases, the child may not be able to leave the
country visited. It is recommended that, before leaving on a trip, you check with the embassy or consulate of the country or countries the
child will be visiting to determine the documentation that may be requested relating to custody of the child.
For further information, contact:
Foreign Affairs, Trade and Development Canada:
Outside Canada
613-944-6788
If a custody dispute could possibly arise while travelling with the child, you should talk to a lawyer prior to your departure. We suggest
that you also read the publication International Child Abduction: A Guidebook for Left-Behind Parents.
You may order a copy online or access an online version at:
Website travel.gc.ca
For a free copy, call:
Phone number 613-944-4000
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PPTC 042 (2015-05) R1
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