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Fillable Printable Request for a Canadian Passport Without Place of Birth

Fillable Printable Request for a Canadian Passport Without Place of Birth

Request for a Canadian Passport Without Place of Birth

Request for a Canadian Passport Without Place of Birth

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REQUEST FOR A CANADIAN PASSPORT
WITHOUT PLACE OF BIRTH
A.
I, , am applying for a new passport and
I do not wish my place of birth to be shown in the passport.
I have been advised by Passport Program, Citizenship and Immigration Canada that I may encounter difficulties with the officials of
other countries such as additional questioning, the requirement to obtain a visa that would not be required if the passport showed my
place of birth, or denial of entry, if the passport does not show my place of birth.
I understand that I will have to apply for a new passport at my expense if I wish my place of birth inscribed in my passport.
B.
I, , am applying for a passport
for , who is under the age of 16, and I do not wish
his or her place of birth to be shown in the passport. I am aware of the warnings provided in section A above.
Signature Date
(AUSSI DISPONIBLE EN FRANÇAIS — PPTC 077F)
PPTC 077E (2014-11) R1
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