Guide 5290 - Live-in Caregivers (text version)

Text version: Request for Police Certificates/Clearances and Authorization for Release of Information

  • Surname
  • Given name(s)
  • Other surname(s) used (example maiden name, previous married names)
  • Name in original script (example Farsi, Arabic, Chinese, etc.)
  • Date of birth (day, month, year)
  • Place of birth
  • Sex (male, female)
  • Citizenship
  • Current address in Canada (number, street, city, province and postal code)
  • Dates
    • From (month, year)
    • To (month, year)
  • Address(es) while resident in (name of country)

I authorize the police or relevant authorities in the country/state named above to disclose to Immigration Canada details about any previous criminal convictions that may exist.

  • Signature of applicant
  • Date (Day, Month, Year)

[End of text version - back to Request for Police Certificates/Clearances and Authorization for Release of Information]

Text version: Fingerprints Request Letter

  • Surname
  • Given name(s)
  • Client ID no.
  • Date of birth (day, month, year)

[End of text version - back to Fingerprints Request Letter]

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