Fillable Form Canadian Passport Application Form - Adult

What is the Canadian Passport Application Form?

The Adult General Passport Application Form is for Canadian applicants who are 16 years of age or over applying in Canada or from the USA for a passport.

How to fill out the Canadian Passport Application Form?

Part 1- Personal Information
Surname
Provide your last name.

Given Name(s)
Enter your first name(s).

Surname at birth
Enter your last name at birth.

Former surname
Provide your former surname.

Place of birth
Enter your place of birth.

Date of birth
Enter your date of birth.

Sex
Select the appropriate choice (Male or Female).

Natural Eye Color
Enter your natural eye color on the space provided.

Height
Provide your height in cm or in.

Current Home Address
Enter your current home address including the street number, apartment, city, province/territory/state, and zip code of where it is located.

Mailing Address
Enter your mailing address including the street number, apartment, city, province/territory/state, and zip code of where it is located.

Telephone(daytime)
Enter your daytime telephone number.

Telephone (other)
Provide any other telephone number you have.

Email Address
Provide your email address.

Signature
Provide your signature.

Date
Enter the date you completed and signed the form.

Signed at
Provide the location where you completed and signed the form.

Part 2- Declaration of Guarantor
This must be filled out with the details of the guarantor and not of the applicant.

Surname
Enter your last name.

Given Name(s)
Provide your first name(s).

Date of Birth
Enter your date of birth.

Canadian Passport Number
Enter your Canadian Passport Number.

Date of issue
Enter the date your Canadian passport was issued.

Date of expiry
Enter the expiry date of your Canadian passport.

Relationship to the applicant
Enter your relationship to the applicant.

Telephone (daytime)
Enter your daytime telephone number.

Telephone (other)
Provide any other telephone number you have.

Current Home Address
Enter your current home address including the street number, apartment, city, province/territory/state, and zip code of where it is located.

Number of Years
Enter the number of years you have known the applicant.

Signature of Guarantor
Provide your signature.

Date
Enter the date you completed and signed the form.

Signed at
Provide the location where you completed and signed the form.

Part 3- Previous Canadian Travel Document
Has a Canadian Travel Document been issued to you?
If a Canadian Travel Document was issued to you before, select “Yes” and enter the number and date it was issued on the space provided. If not, select “No”.

Would you like the previous passport returned to you?
If you like your previous passport to be returned to you, select “Yes, please return it to me.” If not, leave it blank and your previous passport will be securely destroyed by the Passport Program to protect your personal information.

Part 4- Proof of Canadian Citizenship
A- This section will be filled out only if you were born in Canada. Select one (1) from the listed documents (Birth certificate in Canada or Certificate of Canadian citizenship) and enter its number and date of issuance on the space provided.

B-This section is to be completed if you were born outside of Canada.
1- Select one (1) from the listed documents (Certificate of Canadaian citizenship, Certificate of naturalization, Certificate of registration of birth abroad, or Certificate of retention of Canadian citizenship) and enter its number and date of issuance or effectivity on the space provided.

2- This part is to be completed only if you were born outside of Canada between February 15, 1977 and April 16, 1981.

2a- Are you a naturalized Canadian?
If you are a naturalized Canadian, select “Yes” and go to Section 5. If not, select “No” and continue to question 2b.

2b- Was one of your parents born in Canada?
If one of your parents was born in Canada, select “Yes” and go to Section 5. If not, select “No” and complete and submit form PPTC 001 along with this form.

Part 5- Documents to Support Identity
Provide the required information on your supporting documents.

Type of Document
Enter the type of document you are submitting with this form.

Document Number
Provide the document number.

Date of Expiry
Enter the date of expiration of the document.

Your name as it appears on the document
Enter your name as it appears on the document.

Signature of Applicant
Provide your signature.

Date
Provide the date you signed this portion.

Part 6- Period of Validity
Choose one (1) of the following periods of validity
Select the appropriate choice (5-year or 10-year).

Part 7- Additional Personal Information
A. ddresses in the last 2 years
Select whether your addresses in the last 2 years were the same as your current home address or are different. If different, complete the required fields.

B. Occupation in the last 2 years
Check all that applies to you (I was employed, I was in school, or other) and enter the full details on the space provided.

C. Mother’s Maiden Name
Provide your mother’s last name at the time of her birth.

Part 8- References
Provide information of two (2) persons who are not your relatives nor guarantor and are of legal age and know you for at least two (2) years to confirm your identity.

Surname
Enter the last name of your reference person.

Given Name(s)
Enter the first name(s) of your reference person.

Relationship
Provide your relationship with the reference person.

Address
Provide the residential address of your reference person.

Telephone (daytime)
Provide the reference person’s daytime telephone number.

Telephone(other)
Provide another telephone number of the reference person.

Email address
Enter the reference person’s email address.

Has known me for
Enter the number of years the reference person had known you.

Part 9- Emergency Contact Information
Enter the required information for your emergency contact.

Surname
Provide his/her surname.

Given Name(s)
Provide his/her first name(s).

Relationship to the applicant
Provide your relationship with the person.

Telephone(daytime)
Enter his/her daytime telephone number.

Telephone (other)
Enter any other telephone number he/she has.

Email address
Enter his/her email address.

Current Home Address
Enter your current home address including the street number, apartment, city, province/territory/state, and zip code of where it is located.

Signature of Applicant
Provide your signature.

Date
Enter the date you completed and submitted the form.

Submission

Complete this form, gather all your supporting documents and submit either by mail to:

Embassy of Canada
Consular Section
Avenue des Arts 58
B-1000 Brussels

You may choose to also deposit your documents in a closed envelope in the drop-off box located in the entrance of the Embassy in Brussels.