CANADA IMMIGRATION CONSULTING SERVICES

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

STEP - BY - STEP

INSTRUCTION FOR COMPLETING APPLICATION DOCUMENTS

1. Sign the contract. Keep a copy for your file and return the original to CICS - Canada

Immigration Consulting Services.

2. Sign Schedule “A” Individual Consent to Disclosure and/ or Use of Personal Information. Your

spouse and family members over age 18 must sign one form each.

3. Prepare the documents listed in Schedule “D”.

4. Complete the forms under Schedule “E”. Your spouse and each and every member of the family

over age 18 are required to complete one copy each. Make copies for your records. Question 15

must include your high school education and post secondary education (indicate diploma(s)

and/or degree(s) obtained). In Question 16, 17 and 18 mention the details of your job and your

occupation, and include a Resume.

5. Sign Form IMM0008, Schedule “F” where it is marked (X) “Signature of Applicant”. Your

spouse and each and every member of the family over age 18 are required to complete one copy

each. Make copies for your records.

6. Complete the “Additional Family Information” form. Your spouse and each and every member

of the family over age 18 are required to complete this form.

7. Government Fees and Consulting Fees must be sent to the following account:

CICS, Canada Immigration Consulting Services

CICS ENTERPRISES INC. CAN$ ACC # : 03840-003-100-390-4 US$ ACC#: 03840-003-400-127-7 Swift No: ROYCCAT2MIC

ABA No (Transfer form US) 021000021 ROYAL BANK OF CANADA

EDGEMONT VILLAGE 3145 EDGEMONT BLVD

NORTH VANCOUVER, BC V7R 2N7

Government Fees: Refer to Schedule “B”

Consulting Fees: Refer to Schedule “C“

Terms of Payment:

1. 1/2 of the total amount payable now

2. 1/2 of the total amount payable after Medical Exam documents are received.

NOTE: Some professionals need to have their academic records assessed in Canada for the immigration process, i.e. Engineers by CCPE, Canadian Council of Professional Engineers, for which a fee of CAN$175 is payable.

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

I, (full name of client) (the Client), of the City of , hereby retain and appoint Mr. Bahram Sadaghiani, of CICS – Canada Immigration Consulting Services, as my Advisor and Consultant with respect to my application for Permanent Residence of Canada for myself and if applicable for my immediate family members (names of Family members).

The Consultant will provide the following services:

1. Advise the Client with respect to Canadian immigration law 2. Liaise between the Canadian Government and the Client 3. Prepare all forms and submissions

4. Apprise the Client on the progress of his application

5. Prepare the Client for any interview related to the application (if required) 6. Monitor the case progress through completion

I ACKNOWLEDGE that Mr. Bahram Sadaghiani, of CICS - Canada Immigration Consulting Services, has not undertaken to advise me regarding to the tax laws of any country, employment or business opportunities, or any other matters whatsoever except as referred to above.

Mr. Bahram Sadaghiani is a certified member in good standing of CSIC - Canadian Society of Immigration Consultants, Member Number M041595. CSIC - Canadian Society of Immigration Consultants contact information is:

Canadian Society of Immigration Consultants 390 Bay Street, Suite 1600

Toronto, Ontario, Canada, M5H 2Y2 Telephone: 416-572-2800

Toll Free: 1-866-308-CSIC (2742) Fax: 416-572-4114

Email: information@csic-scci.ca

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

(A) FEES

1.

CICS SERVICE FEES US $________

* see Schedule C for CICS Fee Schedule

2. GOVERNMENT FILING FEES CAN $________

*see Schedule B for Government Fee Schedule

3. EDUCATION ASSESSMENT FEES CAN $________

4. DISBURSEMENTS CAN $________

Calculate the Government Processing and Landing Fees:

1 - Principal Applicant

CAN $

2 - Accompanying Spouse

CAN $

3 - Dependent Children

CAN $

4 - Additional Principal Applicants

CAN $

5 - Right of Landing Fee

CAN $

(B) TERMS OF PAYMENT

1. AT THE TIME OF SIGNING THE RETAINER:

1 - Government Processing Fees

CAN$

2 - Education Assessment Fees

CAN$

3 - 50% of CICS Service Fees

US$

2. AFTER THE SELECTION INTERVIEW AND RECEIPT

OF MEDICAL DOCUMENTS:

1- Government Landing Fees (RPRF)

CAN$

2 - Balance of CICS Service Fees

US$

3 - Outstanding Disbursements

CAD$

3. I AGREE TO PAY ANY INCREASE, if any, in Government Fees implemented after signing this Agreement.

4. I AGREE TO PAY ALL DISBURSEMENTS incurred on my behalf to CICS –

Canada Immigration Consulting Services upon rendering an account for same, without regard to the success of the application for permanent residence. Disbursements shall not exceed the sum of CAD $500 without my written authorization. Disbursements include, but are not limited to, all long distance telephone, fax and

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

6. I AGREE TO PAY all outstanding fees and disbursements incurred on my file if I terminate this agreement.

(C) CONDITIONS AND OBLIGATIONS

1. I ACKNOWLEDGE AND AGREE that any information provided by me to Mr. Bahram Sadaghiani and/or CICS - Canada Immigration Consulting Services, may be forwarded or communicated by the said firm or person to any governmental body or any official thereof, if required, as part of or in any way related to my application for permanent residence in Canada, and I hereby give my full and irrevocable consent and authority for the disclosure of such information.

2. I ACKNOWLEDGE AND AGREE that the fees paid to Bahram Sadaghiani and/or CICS - Canada Immigration Consulting Services, do not guarantee my admission to Canada as a Permanent Resident, nor have any representations been made by the said firm or person that the success of my application is guaranteed.

3. I ACKNOWLEDGE AND AGREE that my application will be filed in a Canadian Consulate or High Commission in the continental U.S.A. or any other Visa Office mutually agreed upon, and that I may be required to attend at an interview at the location; however, this does not guarantee that my application will be accepted.

4. I ACKNOWLEDGE AND AGREE that I am responsible for making all necessary applications for Passport(s), Visitors’ Visas etc, and any costs incurred to attend such an interview.

5. I ACKNOWLEDGE AND AGREE that Mr. BahramSadaghiani and/or CICS – Canada Immigration Consulting Services will not be responsible for a refusal decision based on the medical condition, criminality, false information or fraudulent documents of the applicant or any of the family members included in the application.

6. I AGREE to inform Mr. Bahram Sadaghiani and/or CICS - Canada Immigration Consulting Services of any communication received from Citizenship & Immigration Canada and to provide any changes in marital or civic status, address, employment or any other information or circumstances bearing on my case for any person included in my application. Further, if such changes or any other changes require additional services not herein referred to, they shall be agreed upon apart from this commitment.

7. I AGREE that I will complete all required forms as instructed by Mr. Bahram Sadaghiani and/or CICS – Canada Immigration Consulting Services and to obtain all documents and information that may be necessary to process my application.

8. I ACKNOWLEDGE AND AGREE that Mr. Bahram Sadaghiani and/or CICS - Canada Immigration Consulting Services, reserves the right to rescind and revoke this retainer at any time if the information I have provided is found to be untruthful, misleading or false, or if any account rendered by the Consultant or the firm remains unpaid.

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

10. I HEREBY ACKNOWLEDGE having been advised by Mr. Bahram Sadaghiani and/or CICS - Canada Immigration Consulting Services, that amendments to the Immigration Act have been passed which provide immigration officials with the powers to retroactively assess or reassess applications which have been filed prior to the date of such regulations coming into effect and that this may have a negative impact on my application. Neither the Consultant nor the Firm can be responsible for unexpected changes due to the retroactivity provisions or change in Government policies according to the Immigration Act and regulations.

(D) DISCLOSURE

1. I CONFIRM that all information which I have/and will provide to Mr. Bahram Sadaghiani and/or CICS, Canada Immigration Consulting Services, is truthful, accurate and complete, and that any inaccuracies, misrepresentations or failure to disclose with respect to same may seriously affect the approval of my

application for permanent residence or the retention of my Landed Immigrant Status after I and/or any member of my family have landed in Canada.

2. I CONFIRM that neither I nor any other family member included in my application have presented or will present at any future date, false or misleading information or fraudulently obtained or forged

documents to either the Consultant Mr. Bahram Sadaghiani or to his firm CICS – Canada Immigration Consulting Services, or to the Government of Canada.

3. I CONFIRM that I have been advised of AND AGREE that Mr. Bahram Sadaghiani and/or CICS - Canada Immigration Consulting Services may receive or give commission to a 3rd _{party, during the}

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

NOTE: Any questions concerning the provisions of this Retainer Agreement should be addressed to Mr. Bahram Sadaghiani and/or CICS, Canada Immigration Consulting Services, BEFORE SIGNING THIS AGREEMENT.

CLIENT’S FULL NAME: ___________________________________________________________ CLIENT’S FULL ADDRESS: ___________________________________________________________

___________________________________________________________ PHONE NUMBER: ___________________________ CELL No: ____________________________ EMAIL ADDRESS: ___________________________ FAX No: ____________________________

CLIENT’S SIGNATURE: ____________________________________________________________

DATED at ______________________, this ____ day, of ___________________, 200___.

_______________________________________ ________ __________ : ONSULTANT’S SIGNATURE C

Mr. Bahram Sadaghiani, Advisor and Consultant

CSIC Member M041595

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

SCHEDULES

SCHEDULE “A”

INDIVIDUAL CONSENT TO DISCLOSURE

AND/OR USE OF PERSONAL INFORMATION

SCHEDULE “B”

GOVERNMENT FEE SCHEDULE &

PAYMENT OF FEES

SCHEDULE “C”

CICS SERVICE FEES

SCHEDULE “D”

DOCUMENTS REQUIRED

SCHEDULE “E”

PERSONAL, PROFESSIONAL, FINANCIAL

AND FAMILY INFORMATION QUESTIONNAIRE

SCHEDULE “F”

FORMS: LAST PAGE of IMM0008 and

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

“A”

SCHEDULE

S CONSENT TO DISCLOSURE AND

'

INDIVIDUAL

USE OF PERSONAL INFORMATION

(Statement of Authorization)

I, __________________________________, the undersigned, born on ___________,

residing in _______________________, do hereby authorize:

Mr. Bahram Sadaghiani – CSIC Member M041595

CICS - Canada Immigration Consulting Services

716 West 20

th

Street

North Vancouver, BC, Canada, V7P 2B2

Tel: 604 990-9574 Fax : 604 985-9564

•

To represent and act on my behalf as Consultant in all matters under the Immigration

Act 1976-77, c.52, s.1

And authorize

Citizenship and Immigration Canada, Quebec Citizenship and

Immigration as well as Financial institutions in respect of my net worth and

assets information,

authorities to release to the above authorized representative all

records concerning my application and to respond to the above authorized

representative upon any request for information about my file as referred to in the

Access to Information Act, Privacy Act and Freedom of Information and

Protection of Privacy Act

•

And to authorize above-mentioned authorities to forward copies of all correspondence

regarding my application to Mr. Bahram Sadaghiani.

Signed _____________________ on the ______ day of ___________, 20___.

(Applicant)

(Day) (Month)

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

SCHEDULE “B”

GOVERNMENT FEE SCHEDULE

&

INSTRUCTIONS

PAYMENT

ABROAD

S

TO CANADA IMMIGRATION OFFICE

Government Processing and Landing Fees must be made payable to The Receiver General for Canada, in Canadian currency. Payments may be made using a World Money Order or a Certified Cheque. CIC - Citizenship & Immigration Canada, also now accepts payments on-line using Visa or MasterCard. Application payments made directly to CICS – Canada Immigration Consulting Services can be processed as follows:

CICS, Canada Immigration Consulting Services CICS ENTERPRISES INC.

CAN$ ACC # : 03840-003-100-390-4 US$ ACC#: 03840-003-400-127-7

Swift No: ROYCCAT2MIC ABA No (Transfer form US) 021000021

ROYAL BANK OF CANADA EDGEMONT VILLAGE 3145 EDGEMONT BLVD NORTH VANCOUVER, BC V7R 2N7

1. PERMANENT RESIDENCE APPLICATION FEES – NON REFUNDABLE

A) INDEPENDENT/ECONOMIC CLASS: SKILLED WORKER or FAMILY CLASS

DESCRIPTION FEE AMOUNT $ CAN

1 - Principal Applicant $550

2 - Accompanying Spouse $550

3 - Dependent Under Age of 19, Not a Spouse (each) $150

4 – Dependent Over Age of 19 ea. $550

5 – Sponsor Fee $75

B) BUSINESS CLASS: ENTREPRENEUR, INVESTOR or SELF-EMPLOYED

(*for all Provinces except Quebec)

DESCRIPTION FEE AMOUNT $ CAN

1 - Principal Applicant $1050

2 - Accompanying Spouse $550

3 - Dependent Under Age of 19, Not a Spouse (each) $150

4 – Dependent Over Age of 19 (each) $550

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

SCHEDULE “B”

GOVERNMENT FEE SCHEDULE &

PAYMENT INSTRUCTIONS TO CANADA IMMIGRATION OFFICES ABROAD

Page 2

C) BUSINESS CLASS: ENTREPRENEUR, INVESTOR or SELF-EMPLOYED

(*for Quebec only)

DESCRIPTION FEE AMOUNT $ CAN

1 – Investor - Principal Applicant $3850

2 – Entrepreneurs - Principal Applicant $950

3 – Self-employed Workers – Principal Applicant $950

2 - Accompanying Spouse $550

3 - Dependent Under Age of 19, Not a Spouse (each) $150

4 – Dependent Over Age of 19 (each) $550

2. RIGHT OF LANDING FEE – REFUNDABLE IF APPLICATION REFUSED

The Right of Landing Fee (ROLF), also known as Right of Permanent Residence Fee (RPRF) is CAN $975.00 and is payable by all adult immigrants 19 years of age and over who apply to become Permanent Residents of Canada. Accompanying family members who are under 19 years of age are not required to pay this fee.

3. STUDENT VISA AUTHORIZATION – NON REFUNDABLE

CAN $125.00 must be paid to the Canadian Visa Offices abroad when an application for Student VISA Authorization is filed.

4. INFORMAL ASSESSMENT FEES – NON REFUNDABLE

Professional associations charge a fee for informal assessment of qualifications. Different institutions charge different fees. CICS – Canada Immigration Consulting Services provides a Free Assessment

at our website,

www.cicsgroup.com

.

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

SCHEDULE “C”

CANADA IMMIGRATION CONSULTING SERVICES

-ICS

C

.

FEE SCHEDULE

1. Standard Fee for applying for Permanent Residence in Canada (Immigrate) as a Skilled Worker/Family Class Applicants:

- Family (husband, wife and dependent children) US $ 4,950

- Single Person US $ 3,950

2. Standard Fee for applying for Permanent Residence in Canada (Immigrate) for Business Class Applicants:

- Entrepreneur or Investor Category US $ 6,950

3. Standard Fee for applying for Permanent Residence under

a Sponsorship US $ 3,950

4. Standard Fee for applying for Student Visa

Authorization US $ 2,950

5. Subject Removal – Depending on the case, the service fee

varies from CAN $1,000-$5,000. Fee Varies

6. Personal consultations with CICS representatives are

charged on an hourly fee. CAN $150/hr.

NOTE: In order to assess the eligibility of the applicant and determine the Category under which the applicant stands a better chance for obtaining a Visa for Permanent Residency in Canada, a case study will be conducted by CICS – Canada Immigration Consulting Services. Based on the personal, professional, financial and family status considerations, the “CLIENT” will be advised to proceed for applying for permanent residency Visa. Payment must be made by Money Order or be transferred to the account mentioned herewith below.

CICS, Canada Immigration Consulting Services CICS ENTERPRISES INC.

US $ Acc# 03840-003-400-127-7 CAN$ ACC# : 03840-003-100-390-4 ROYAL BANK OF CANADA EDGEMONT VILLAGE 3145 EDGEMONT BLVD

NORTH VANCOUVER, BC, V7R 2N7

*There will be a US$ 400 courier charge for all categories in case the applicant demands that courier service be used.

*

Payment must be made for applications for Skilled Workers and Family Class/Sponsored Relatives (Economic category), and

Entrepreneurs or Investors (Business Classcategory) or Student Visa Authorization, paymentmust be made by Money Order,

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

“D”

SCHEDULE

DOCUMENTS REQUIRED FOR APPLYING FOR

PERMANENT RESIDENCE IN CANADA

Where marked, relevant document must be sent to CICS Canada Immigration Consulting

Required

Documents

Original Presented at interview Photocopy of Originals Original of translation

Remarks

⇒ Valid passport for:

Principal applicant, Spouse and Dependent children

⇒ Birth Certificate

Principal applicant, Spouse and Dependent children

⇒ Marriage Certificate

⇒ Divorce/ Separation

certificate and custody documents

⇒ Educational degrees,

diplomas, certificates and/or transcripts for Principal applicant, Spouse and Dependent children Over age 18

⇒ Letters of reference from

employers for Principal applicant/ Spouse

⇒ Evidence of Funds

⇒ Property deeds and proof

of ownership for

Principal applicant, Spouse and Dependent children

⇒ Police certificates for Principal applicant, Spouse and Dependent children over 18 Years

⇒ Proof of relation to your

relatives in Canada.

⇒ 7 PCs passport size Photos

for all family members

Please mark √ when documents are sent to CICS Canada Immigration Consulting Services. Indicate N/A where not applicable.

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

SCHEDULE “E”

QUESTIONNAIRE FOR THE PURPOSE OF ASSESSMENT OF ELIGIBILITY FOR OBTAINING

PERMANENT RESIDENCE IN CANADA

*All Questions MUST be answered in full.

QUESTION 1

SURNAME(FAMILY NAME) _____________________________________________________________________________ GIVEN NAME (S) ____________________________________________________________________________________ ALL OTHER NAMES I HAVE USED ______________________________________________________________________ FULL NAME IN SCRIPT OF MY NATIVE LANGUAGE

(eg. ARABIC SCRIPT, CYRILLIC ALPHABET, CHINESE,

KOREAN OR JAPANESE CHARACTERS) _____________________________________________________________________________________

QUESTION 2

SEX: MALE _____ FEMALE _____

EYE COLOR: _______________ HEIGHT: _________________

QUESTION 3

DATE OF BIRTH DAY _____ MONTH _____________________ YEAR _______ CURRENT AGE __________ PLACE OF BIRTH CITY ____________________________________ COUNTRY ________________________________

QUESTION 4

COUNTRY OF CITIZENSHIP

_____________________________________________________________

QUESTION 5

PERMANENT HOME ADDRESS: Street Address _____________________________________________________________

City ___________________________________ Zip/Postal Code ___________________

Country __________________________________________________________________

CURRENT MAILING ADDRESS: Street Address _____________________________________________________________

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

CONTACT INFORMATION: Home Telephone __________________________________________________________

Work Telephone ___________________________________________________________

Cell / Mobile ______________________________________________________________

Email ____________________________________________________________________

QUESTION 7

MARITAL STATUS: EVER MARRIED

□

ENGAGED

□

MARRIED

□

WIDOWED

□

SEPARATED

□

DIVORCED

□

(*Check more than one if applicable.)

QUESTION 8

DATE OF MARRIAGE DAY _____ MONTH _______________________ YEAR _______

PLACE OF MARRIAGE CITY ________________________________ COUNTRY ___________________________ I HAVE BEEN MARRIED MORE THAN ONCE NO ______ YES ______ IF YES, HOW MANY TIMES? __________

QUESTION 9

PERSONAL DETAILS OF ALL MY DEPENDANTS)

FAMILY NAME FIRST _NAME PLACE _OF

BIRTH DATE OF BIRTH D / M / Y MARITAL STATUS RELATION-SHIP TO ME ACCOMPANYING ME TO CANADA (SPOUSE) YES

□

NO

□

YES

□

NO

□

YES

□

NO

□

YES

□

NO

□

_YES

□

_NO

□

YES

□

NO

□

YES

□

NO

□

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

QUESTION 10

PASSPORT DETAILS FOR PRINCIPAL APPLICANT AND ALL PERSONS LISTED IN QUESTION 9

NAME ON PASSPORT PASSPORT # PLACE OF

BIRTH CITIZEN _OF DATE OF _EXPIRY IDENTITY CARD _NO

A. (PRINCIPAL APPLICANT) B. (SPOUSE) C D E F

(*To be completed by Principal Applicant only)

QUESTION 11

MY ABILITY IN FRENCH AND ENGLISH

ABILITY IN ENGLISH ABILITY IN FRENCH

SPEAK

Fluently

□

Well

□

With difficulty

□

Not at all

□

Fluently

□

Well

□

with difficulty

□

Not at all

□

READ

Fluently

□

Well

□

With difficulty

□

Not at all

□

Fluently

□

Well

□

with difficulty

□

Not at all

□

WRITE

Fluently

□

Well

□

With difficulty

□

Not at all

□

Fluently

□

Well

□

with difficulty

□

Not at all

□

MY MOTHER TONGUE IS :

QUESTION 12

MY EDUCATION YEARS OF ELEMENTARY SCHOOL YEARS OF SECONDARY SCHOOL YEARS OF UNIVERSITY/

COLLEGE YEARS OF FORMAL APPRENTICESHIP /

TRAINING

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

QUESTION 13

DETAILS OF MY SECONDARY AND POST-SECONDARY EDUCATION

FROM

M Y

TO

M Y

NAME OF INSTITUTE CITY AND

COUNTRY

TYPE OF CERTIFICATE

(*Include Apprenticeship Training)

QUESTION 14

MY PRESENT OCCUPATION IS: _______________________________________________________________ MY CURRENT GROSS MONTHLY EARNING: _______________________________________________________________ MY INTENDED OCCUPATION IN CANADA IS: _______________________________________________________________

QUESTION 15

WORK HISTORY FOR THE PAST 10 YEARS

DATES FROM TO M / Y M / Y

NAME OF EMPLOYER

(WRITE NAME IN FULL, DO NOT USE ABBREVIATIONS)

CITY AND COUNTRY

OCCUPATION _SALARY

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

QUESTION 16

THE FOLLOWING PERSON, EMPLOYER OR ORGANIZATION IN CANADA HAS OFFERED TO ASSIST ME AFTER ARRIVAL

___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________

(*Name and Address, Include a Copy of the Job Offer, if you have one.)

QUESTION 17

RELATIONSHIP TO ME OF PERSON NAMED IN QUESTION 16 ____________________________________________

QUESTION 18

MY DESTINATION IN CANADA: CITY/TOWN ________________________________ PROVINCE ____________________

QUESTION 19

I HAVE THE FOLLOWING ASSETS (Show $ Amount)

DETAIL DOLLAR AMOUNT

TRANSFERABLE MONEY

PROPERTY MONTHLY TRANSFERABLE PENSION

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

QUESTION 20

I HAVE THE FOLLOWING DEBTS OR LEGAL OBLIGATIONS (eg. Monthly Child Support Payments) OWING TO (give name of person or

organization)

TOTAL DEBT

QUESTION 21

SINCE MY 18TH BIRTHDAY, I HAVE LIVED AT THE FOLLOWING ADDRESSES:

DATES FROM TO

M / Y M / Y STREET ADDRESS AND NUMBER

CITY OR

TOWN COUNTRY

QUESTION 22

SINCE MY 18TH BIRTHDAY I HAVE BEEN (or still am) A MEMBER OF AND/OR ASSOCIATED WITH THE FOLLOWING SOCIAL, YOUTH, STUDENT OR VOCATIONAL ORGANIZATIONS, INCLUDING TRADE UNIONS AND

PROFESSIONAL ASSOCIATIONS, INCLUDING ANY MILITARY SERVICE (show Rank, Unit and Location of service in last column).

DATES FROM TO M / Y M / Y

NAME AND ADDRESS OF ORGANIZATION

TYPE OF

ORGANIZATION POSITION

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

QUESTION 23

DETAILS OF MY PARENTS MY PARENTS DATE OF BIRTH D / M / Y

CITY TOWN AND COUNTRY OF BIRTH

PRESENT ADDRESS IN FULL (IF DECEASED GIVE DATE)

QUESTION 24

HAVE YOU OR HAS ANY ONE OF THE PERSONS IN QUESTION 9 EVER: YES NO

(ANSWER “YES” OR “NO")

A. HAD ANY SERIOUS DISEASE OR PHYSICAL OR MENTAL DISORDER? _____ _____

B. BEEN CONVICTED OF OR IS CURRENTLY CHARGED WITH ANY

CRIME OR OFFENCE IN ANY COUNTRY? _____ _____

C. APPLIED PREVIOUSLY FOR AN IMMIGRATION VISA TO CANADA? _____ _____

D, BEEN REFUSED AN IMMIGRANT OR VISITOR’S VISA TO CANADA,

OR ANY OTHER COUNTRY? _____ _____

E. BEEN REFUSED ADMISSION TO OR ORDERED TO LEAVE CANADA,

OR ANY OTHER COUNTRY? _____ _____

F. IN PERIODS OF EITHER PEACE OR WAR, HAVE YOU EVER BEEN INVOLVED IN THE COMMISSION OF A WAR CRIME OR CRIME AGAINST HUMANITY, SUCH AS WILLFUL KILLING, TORTURE, ATTACKS UPON OR ENSLAVEMENT OR STARVATION OR OTHER INHUMANE ACTS, COMMITTED AGAINST

CIVILIANS OR PRISONERS OF WAR, OR DEPORTATION OF CIVILIANS? _____ _____

IF THE ANSWER TO ANY OF THE ABOVE IS “YES” PROVIDE DETAILS HERE:

___________________________________________________________________________________________________ ___________________________________________________________________________________________________

QUESTION 25

WHERE WOULD YOU LIKE TO HAVE

YOUR INTERVIEW CONDUCTED? DAMASCUS _____ TEHRAN _____ OTHER _______________________

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

SCHEDULE “F”

PART C

1 - SINCE MY 18TH _{BIRTHDAY, I HAVE BEEN (OR STILL AM) A MEMBER OF, OR ASSOCIATED WITH, THE FOLLOWING POLITICAL, SOCIAL,}

YOUTH, STUDENT OR VOCATIONAL ORGANIZATIONS, TRADE UNIONS OR PROFESSIONAL ASSOCIATIONS. INCLUDE MILITARY SERVICE (SHOW RANK, UNIT AND LOCATION OF SERVICE IN LAST COLUMN)

DATES

FROM M Y

TO

M Y Name and address of organization Type of organization Position held (if any)

PRESENT

2 MY PARENTS

Father’s full name

Date of birth

Day Month Year

City or town of birth:

Country of birth:

If deceased give date:

Day Month Year

/ /

Mother’s full name before marriage:

Date of birth

Day Month Year

City or town of birth:

Country of birth:

If deceased give date: Day Month Year

/ /

3 – AUTHORITY TO DISCLOSE PERSONAL INFORMATION

A. I understand that the Canadian Government will contact any government authority, including police, judicial and state authorities in all countries in which I have resided, to seek the release to the Canadian Government authorities of all records and information that they may possess on my behalf concerning any investigations, arrests, charges, trials, convictions and sentences. I understand that this information will be used to assist in evaluating m suitability for admission to Canada or remaining in Canada, pursuant to Canadian immigration legislation.

B. I also authorize the release of information from my Immigration records to : (check one or more) The individual named hereinafter:

My sponsor

My Canadian representative (if any)

Name of individual Bahram Sada-Giani Name of firm: CICS , Canada Immigration Consulting Services Inc

x______________________________________________ Signature of applicant

Date 4. DECLARATION OF THE APPLICANT

- I declare that the information I have given in this application is truthful, complete and correct.

- I understand that any false statements or concealment of a material fact may result in my exclusion from Canada, and may be grounds for my prosecution and/or removal.

- I understand all the foregoing statements, having asked for and obtained an explanation on every point which was not clear to me.

Signature of applicant:

x

_______________________________

Date

DO NOT COMPLETE THE FOLLOWING SECTION NOW. YOU WILL BE ASKED TO SIGN IT IN THE PRESENCE OF A REPRESENTATIVE OF THE CANADIAN GOVERNMENT OR OFFICIAL APPOINTED BY THE CANADIAN GOVERNMENT.

5. SOLEMN DECLARATION

I, __________________________________________, SOLEMNLY DECLARE THAT THE INFORMATION I HAVE GIVEN IN THE FOREGOING APPLICATION IS TRUTHFUL, COMPLETE AND CORRECT, AND I MAKE THIS SOLEMN DECLARATION CONSCIENTIOUSLY BELIEVING IT TO BE TRUE AND KNOWING THAT IT IS OF THE SAME FORCE AND EFFECT AS IF MADE UNDER OATH. _

SIGNATURE OF THE APPLICANT ___________________________

INTERPRETER DECLARATION

I, __________________________________________, do solemnly declare that I have faithfully and accurately interpreted in the __________________ language the content of this application and any related forms to the person concerned.

I have been informed by the person concerned, and I do verily believe, that he/she completely understands the nature and effect of these forms, and I make

Day … Month……… Year 20

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

Information Act, individuals have the right to protection of and access to their personal information. Instructions for obtaining information are provided in Info Source, a copy of which is

C

ANADA

I

MMIGRATION

C

ONSULTING

S

ERVICES

SCHEDULE "F"

Citizenship and Immigration Canada Citoyennete et Immigration Canada ADDITIONAL FAMILY INFORMATION

Complete ALL names in English and in your native language (for example, Arabic, Cyrillic, Chinese commercial/telegraphic code, Korean, or Japanese characters)

SECTION A

Name Relationship Date of birth

Day Month Year Place of birth Marital status Present address

Applicant

SEE NOTE 1 Spouse

Mother

Father

NOTE 1: If no spouse is listed in Section A, read and sign below

I certify that I do not have a husband or a wife and that I have never been married before

………. Signature

SECTION B: CHILDREN (Include ALL sons and daughters, including ALL adopted and step-children, regardless of age or place of residence)

Name Relationship

SEE NOTE 2 Day Month Year Date of birth Place of birth Marital status Present address

NOTE 2: If no children are listed in Section B, read and sign below

I certify that I do not have any children, either natural or adopted

……….

Signature _Date

SECTION C: BROTHERS AND SISTERS ( Include half- and step-brothers and sisters)

Name Relationship

Day Month Year Date of birth Place of birth Marital status Present address

SECTION D: CERTIFICATION

I certify that the information contained on this document is complete, accurate and factual. I also realize that once this document has been completed and signed that it will form part of my immigration Record and will be used to verify my family details on further applications

Day Month Year …….. ………. 200.. Day Month Year …….. ………. 200..