Sponsor Assessment Form (IMM 5492)
Download the form
Sponsor Assessment Form [IMM 5492] (PDF, 1.8 MB)
How to download, save and open this form
- Use your computer. The form may not open on tablets or mobile phones.
- Save the form on your computer in a place you can remember.
- For most Internet browsers, clicking on the link above will automatically download the form.
- If the form doesn’t automatically download, right-click on the link and select “Save as.”
- After you download the form, open it using Adobe Acrobat Reader.
Open this form in Acrobat Reader
- Open Acrobat Reader.
- You need Acrobat Reader version 10 or higher to open our forms.
- Get the latest version of Acrobat Reader.
- Select “File” from the top menu.
- Click “Open.”
- Find the location where you saved the form, click on the file, and click “Open.”
Complete the form
Read the step by step instructions on how to complete the form.
Sponsor Assessment (IMM 5492)
If you’re applying under Sponsorship Agreement Holders
Who must fill out this application form?
This form must be completed by the:
- Sponsorship Agreement Holder (SAH) – (unless the form is kept on file with IRCC)
- Constituent Group (if applicable)
What is it?
All persons who intend to sponsor refugees must meet the sponsor eligibility criteria established by the Immigration and Refugee Protection Regulations. Each party to the sponsorship (those who sign the undertaking) must complete the Sponsor Assessment to confirm their eligibility.
Individuals who are deemed ineligible to sponsor will have their applications returned to them. If you wish to clarify your response to a certain question, provide details on a separate sheet.
Group members may wish to submit their Sponsor Assessment in a sealed envelope to ensure confidentiality. Be advised that the local IRCC office reserves the right to require official documentation to support any aspect of your Sponsor Assessment.
Note: The representative of a Sponsorship Agreement Holder may complete the Sponsor Assessment form and submit it to IRCC National Headquarters to be kept on file instead of having to complete the form for each sponsorship application.
Section A
Write the name of the sponsoring group (print clearly).
Section B
Write the last name (surname/family name) and given name(s) of the sponsor representative or individual sponsor (print clearly).
Section C
Write any other name(s) used (including birth name, maiden, previous married name(s), aliases and nicknames) of the sponsor representative or individual sponsor (print clearly).
Section D
Check the box to indicate if you are at least 18 years of age or older.
Section E
Check the box to indicate if you are a Canadian citizen, a registered Indian or a permanent resident.
Section F
Check the box to indicate if you or your representatives reside in the expected community of resettlement.
Section G
Check the box if you have been convicted, in Canada of the offence of murder or an offence set out in the schedule I or II of the Corrections and Conditional Release Act.
Or
Check the box if you have been convicted of an offence outside Canada that, if committed in Canada would constitute one of the offences referred to above.
Note: the schedules I and II are attached with the form.
Section H
Check the box to indicate if you are in default of any court-ordered support payment obligations.
Section I
Check the box to indicate if you are currently detained in any penitentiary, jail, reformatory or prison.
Section J
Check the box to indicate if you have ever been ordered to leave Canada.
Section K
Check the box to indicate if you are subject to any revocation proceedings under the Citizenship Act.
Section L
Check the box to indicate if you authorize IRCC to disclose to the remaining parties that you cannot be a party to the sponsorship in the event that you are found to be ineligible.
Section M - Signature
Sign and date the form. If a signature is missing, the application may be returned.
If you’re applying under Groups of Five
This form must be completed by each sponsor in a Group of Five.
Common errors when submitting
- form was not submitted by each G5 sponsor
- invalid version of form was submitted
- not all questions were answered
- form was handwritten
- form was not signed and dated
Section A
Does not apply to G5 sponsors.
Section B
Type your family name and given names.
Section C
Type any other names you have used (including birth name, maiden name, previous married names, aliases and nicknames).
Section D to L
Check the appropriate box. If a box is not checked, the application may be returned.
Section M – Signatures
Sign and date the form. If a signature is missing, the application may be returned.
If you’re applying under Community Sponsors
This form must be completed by:
- the CS Signing Authority
- the individual co-sponsor (if applicable)
- the organizational co-sponsor Signing Authority (if applicable)
Common errors when submitting the form:
- form was not submitted for each sponsor
- invalid version of form was submitted
- not all questions were answered
- form was handwritten
- form was not signed and dated
Section A
Type the name of the CS.
Section B
Type your family name and given names.
Section C
Type any other names you have used (including birth name, maiden name, previous married names, aliases and nicknames).
Section D to L
Check the appropriate box.
If a box is not checked, the application may be returned.
Section M – Signatures
Sign and date the form. If a signature is missing, the application may be returned.
Page details
- Date modified: