Adult Travel Document Application: For Stateless and Protected Persons in Canada (16 Years of Age or Over)
Adult Travel Document Application: For Stateless and Protected Persons in Canada (16 Years of Age or Over)
Type or print in CAPITAL LETTERS using black or dark blue ink. Read Instructions
1 PERSONAL INFORMATION (SEE INSTRUCTIONS, SECTION F) Anticipated date of travel
Surname (last name) requested to appear in the travel document It is recommended that you do not
finalize travel plans until you receive
the requested travel document.
Given name(s) requested to appear in the travel document UCI Month Day
Unknown
All former surnames (including surname at birth if different from above. These will not appear in the travel document.)
Place of birth
Declaration—I understand that if I am issued a Canadian travel document and later obtain a Sign within border
passport issued by my country of citizenship, I am obliged to return the Canadian travel
document to the Passport Program, Immigration, Refugees and Citizenship Canada. I
solemnly declare that the photos enclosed are unaltered and a true likeness of me, that all of
the statements made and the information provided in this application, as well as any
supporting documents, are true. I declare that I have read and understood the Warning at the
top of this page and the Privacy Notice Statement (see section M). I consent to the
collection, use and disclosure of my personal information by the Passport Program, Signature (see Instructions, section F)
Immigration, Refugees and Citizenship Canada, other federal government institutions,
Government of Canada offices abroad and third party entities as outlined in the Privacy Notice Date (YYYY-MM-DD) Signed at
Statement in the Instructions.
City Prov./Terr.
Business address
Read Instructions
3 PROOF OF IMMIGRATION STATUS IN CANADA (SEE INSTRUCTIONS, SECTION I)
To establish your immigration status in Canada, provide a photocopy of one (1) of the following valid documents and write the requested information:
Permanent resident card Temporary resident permit Verification of status
Notice of decision issued by the Immigration and Positive pre-removal risk assessment
Refugee Board of Canada results letter
Immigration status document number Date of issue (YYYY-MM-DD) Date of expiry (YYYY-MM-DD if applicable)
Your previous Certificate of Identity or Refugee Travel Document will be securely destroyed unless it contains a valid visa and you have made a request
to have it returned to you.
Note: If a Canadian travel document has been reported lost, stolen, damaged or is inaccessible, and has not yet expired, complete form PPTC 203,
Declaration concerning lost, stolen, inaccessible, damaged or found Canadian travel document, available online at Canada.ca/passport. A Canadian travel
document is no longer valid if damaged or reported as lost, stolen, or inaccessible. There is an administrative fee for the replacement of a lost or stolen
Canadian travel document that has not yet expired.
Indicate country
Have you acquired any other citizenship? No Yes, Indicate country
Do you have any valid travel document or passport from any country other than Canada?
Have you visited another country since your entry to Canada? No Yes, specify
Have you, since your date of entry to Canada, applied for a passport or travel document (or renewal of such a document) from your country of origin or
citizenship?
No, provide a detailed explanation of your reasons for not applying.
Yes, if the request was refused, enclose the letter of refusal. If unable to provide this letter, explain why. If no reply was received, write all the steps you
have taken
Type of document Document number Date of expiry (If applicable) (YYYY-MM-DD) Your name as it appears on the document
Read Instructions
7 ADDITIONAL PERSONAL INFORMATION
Note: If insufficient space, attach a separate signed and dated sheet.
A Addresses in the last two (2) years
Same as current home address
Different from current home address (complete below)
1. From (YYYY-MM) To (YYYY-MM)
Enter full details below for the last two (2) years:
Employer, school or other Address Telephone (daytime) Field of employment or studies Date (from) Date (to)
8 REFERENCES
Provide the following information for two (2) persons who are neither your relatives nor your guarantor; are 18 years of age or over; and who have known
you for at least six (6) months. They must agree to have their contact information provided as they may be contacted to confirm your identity.
Visit Canada.ca/passport for more information on the Passport Program's definition of a relative.
1. Surname (last name) Given name(s) Relationship to the applicant
Address
Address
Complete Form
ADULT TRAVEL DOCUMENT APPLICATION
for stateless and protected persons in Canada (16 years of age or over)
INSTRUCTIONS
A ENTITLEMENT TO A CANADIAN TRAVEL DOCUMENT
Important notice: We recommend that you not finalize your travel plans until you receive the requested travel document.
A Canadian travel document reflects the identity of the applicant as determined by proof of immigration status in Canada, issued by Immigration, Refugees and
Citizenship Canada and documents to support identity.
• Refugee travel document: issued to persons in Canada with protected person status, including Convention refugees and persons in need of protection.
• Certificate of identity: issued to permanent residents of Canada who are not protected persons and who are stateless or are unable to obtain a national passport.
Warnings:
• Some countries may not accept the certificate of identity as a valid travel document. You should check with the consulate or embassy of the country you will
be visiting before applying for a certificate of identity.
• Canadian refugee travel documents and Canadian certificates of identity are not valid for travel to the bearer's country of citizenship.
• For stateless and protected persons in Canada under 16 years of age, use form PPTC 192, Child Travel Document Application.
• Eligibility for either a travel document or a certificate of identity can be determined only after all required information has been submitted and reviewed. These
documents are issued only in Gatineau, Quebec.
• If you are issued a Canadian travel document and you later obtain a travel document or a passport issued by your country of citizenship, you must return
the Canadian travel document to the Passport Program.
B REQUIREMENTS CHECKLIST
All three (3) pages of the application form completed and signed within Any non-expired Canadian refugee travel document or Canadian
the last twelve (12) months and certified by the guarantor certificate of identity issued to you in the last five (5) years
Two (2) identical and unaltered passport photos taken within the last six Any valid foreign travel document or national passport issued to you or in
(6) months, one (1) certified by the guarantor which your name appears
A photocopy of a valid proof of immigration status to Canada; The fee
Document(s) to support identity (original or copies); copies must be
signed and dated by your guarantor
Note: All documents submitted as part of the travel document application that are in a language other than English or French must be accompanied by a translation completed
by a certified translator.
C FEE
Refugee Travel Document - CAN$120* Certificate of Identity - CAN$260*
*A CAN$25 consular services fee is included in the above-mentioned fee.
All applicants must pay the required fees for a Certificate of Identity or a Refugee Travel Document. Applicants must pay the fees for the document they wish to apply for. Please
refer to the definitions in Section A. If the Passport Program, part of Immigration, Refugees and Citizenship Canada, determines that you are not eligible for the document for which
you paid, you will be required to pay the remaining balance or you will receive a refund.
There is a separate, non-refundable CAN$45 administrative fee for the replacement of a lost or stolen Canadian travel document that has not yet expired.
Methods of payment (Canadian funds only): Important
If you are applying by mail (2 options):
• Every person who requests travel document services must pay the
• Pay your fees online and include a copy of the receipt with your application; or applicable fee in the exact amount.
• Issue a certified cheque or money order (postal or bank) in the exact amount, • Applicants who cancel their application or are refused a Canadian refugee
payable to the Receiver General for Canada. travel document or certificate of identity are not eligible for a refund of the
! In-person payment not available because of COVID-19 service fee. Only the consular services fee of CAN$25, applied only to
adult applications, is refundable.
If you are applying in-person, you can pay by:
• Administrative fees and applicable interest will be applied to all
• Debit card (Interac), Visa Debit, Virtual Visa Debit or other prepaid cards dishonoured payments.
(Visa, MasterCard, American Express) only for in-person applications
submitted by the cardholder. Prepaid debit cards are not accepted; • Fees are subject to change.
• Credit card and prepaid card (embossed only); In cases where services do not meet established service standards,
• Certified cheque or money order (postal or bank) in the exact amount, applicants may be eligible for partial compensation of service fees.
payable to the Receiver General for Canada; For information on Service Standards please visit Canada.ca/immigration-
• Cash and personal cheques are not accepted. refugees-citizenship.
D WHERE TO APPLY
Mailed-in applications are processed in Canada.
By mail By courier Do not mail or bring your application form to any other Passport Program
OSC PPT-COI Centralized Network – Certificate service location.
PO BOX 8783 STN T CSC of Identity Section Place du Centre, The original documents that you enclose with your application are valuable.
OTTAWA ON K1G 5G8 Commercial Level 2 We recommend that you use a courier or mail service that allows you to track
200 Promenade du Portage your package.
Gatineau QC J8X 4B7
Complete Form
E CONTACT INFORMATION
• Automated telephone service is available 24 hours a day, 7 days a week. Agents are available Monday to Friday from 8:00 a.m. to 4:00 p.m. (Eastern time) in
Canada.
• The travel document application instruction booklet in Braille is available upon request only. For more information or to order that format, contact the Passport
Program.
F PERSONAL INFORMATION
Surname (last name) and given name(s) requested to appear in travel document
Write the name to appear in the travel document. This name is normally the same as the surname (last name) and given name(s) shown on your proof of
immigration status. If you are requesting a travel document in a name that is different from the name that appears on the immigration status document, please
note the following:
• For a change of surname resulting from a relationship, you must provide an original or copy of a marriage or common-law relationship certificate, or a
document demonstrating termination of the relationship (indicating both previous and current surname).
• For any other legal name change, include one (1) of the following:
• A legal change of name order;
• An adoption order; or
• Proof that the record of entry at Immigration, Refugees and Citizenship Canada has been amended, i.e. the approved form IMM 1436, Request to
Amend the Record of Landing, Confirmation of Permanent Residence or Valid Temporary Resident Documents.
All former surnames
All former surnames that differ from the surname requested to appear in the travel document, including your surname at birth, must be declared. These former
surnames will not appear in the travel document.
UCI
Indicate your Unique Client Identifier number (UCI) or Client Identification number (Client ID). It is a 8 or 10 digit number as it appears on your immigration
document.
Mother's surname at birth
Indicate your mother's surname (last name) at birth.
Date of birth
The date of birth will be inscribed in the travel document exactly as it appears on the proof of immigration status unless Immigration, Refugees and Citizenship
Canada records have been amended subsequent to your admission to Canada. In this case, the original approved form IMM 1436, Request to Amend the
Record of Landing, Confirmation of Permanent Residence or Valid Temporary Resident Documents, is required. If your proof of immigration status does not
show a complete date of birth, the specific year, month and day of your birth will be entered as shown on your supporting identification. Provide original
supporting identification showing that date of birth or copies signed and dated by your guarantor.
Sex
If the sex requested to appear in the travel document does not match the Immigration Status Document, additional requirements must be met.
Visit Canada.ca/passport for more details.
Current home address and Mailing address (if different from current home address)
Your passport will be delivered to the mailing address provided. If your mailing address changes within 30 days of submitting your application, you must notify
the Passport Program (see section E).
Signature
You must sign your usual signature
on all three (3) pages.
Complete Form
H DECLARATION OF GUARANTOR
A guarantor is a person other than yourself who confirms your identity. A family member or a person who resides at the same address as the applicant may be
the guarantor provided that this individual meets the specified requirements.
The guarantor must:
• be a Canadian citizen or a permanent resident living in Canada;
• have known you (the applicant) personally for at least six (6) months. To know you personally means to be able to confirm aspects of your personal
attributes;
• know you well enough to be confident that the statements you have made on the application form are true;
• be accessible to the Passport Program for verification;
• Currently be a member of one of the following professions or guarantor occupations:
• Dentist, medical doctor or chiropractor • Postmaster
• Judge, magistrate or police officer (municipal, provincial or RCMP) • Principal of a primary or secondary school
• Lawyer (member of a provincial bar association), or notary in Quebec • Professional accountant (member of APA, CA, CGA, CMA, PA or RPA)
• Mayor • Professional engineer (P. Eng., Eng. in Quebec)
• Minister of religion authorized under provincial or territorial law to • Senior administrator in a community college (including CEGEP)
perform marriages
• Notary public • Senior administrator or teacher in a university
• Optometrist • Veterinarian
• Pharmacist
The above list is not a recognition or endorsement by the Passport Program, Immigration, Refugees and Citizenship Canada of professional status or
superior qualifications
You or your guarantor can complete this section, with the exception of the four fields in bold which must be completed by your guarantor.
The guarantor must perform the following three (3) tasks free of charge:
1. Complete or validate the information entered in the section Declaration of Guarantor (section 2). The guarantor must complete the four fields in bold:
1) I have known the applicant for (number of months), 2) Signature of guarantor, 3) Date, 4) Signed at. Ensure you have completed and signed all
three (3) pages of the application before submitting it to your guarantor.
2. Write "I certify this to be a true likeness of (your name)" on the back of one (1) of your photos and sign it.
3. If applicable, sign and date a copy of each document to support your identity (see section L).
The Passport Program reserves the right to request a new guarantor.
The applicant must not assist the guarantor in performing their duties. If your guarantor requires assistance, contact the Passport Program.
If you have not known an eligible guarantor for at least six (6) months, complete form PPTC 326, Statutory Declaration in Lieu of Guarantor for a Travel
Document, available at any Passport Program regional office or contact the Passport Program (see section E). The form must be completed at your expense
before a person who is authorized by law to administer an oath or solemn affirmation. This may delay the processing time of the Canadian travel
document.
36 mm (1 7/16 in.)
Minimum Face Height
Photo taken
Frame Height 70 mm (2 3/4 in.)
31 mm (1 1/4 in.)
Date
• show a neutral facial expression (no smiling, mouth closed) and looking straight
at the camera, with eyes open and clearly visible;
I certify this to be a
• have uniform lighting—no shadows, glare or flash reflections; true likeness of
• show a full front view of the face and top of the shoulders squared to the camera (applicant's name)
(face and shoulders centered in the photo, head not tilted or turned);
• reflect natural skin tone and be taken against a plain white or light coloured
background with enough contrast between the background, facial features and
clothing, so that your features appear clearly against the background; Guarantor's Signature
• be originals that have not been altered in any way and not taken from an
• existing photo;
Frame Width 50 mm (2 in.)
• be taken within the last six (6) months from the date the application is submitted
and reflect your current appearance. Not actual size (refer to measurements above)
Additional information
• Prescription glasses may be worn in photos as long as there is no glare and the eyes are clearly visible.
• The red-eye effect, tinted glasses and sunglasses make the photos unacceptable.
• Hats and head coverings must not be worn, except for religious beliefs or medical reasons. The head covering and hair must not cast shadows on the face
and the full face must be clearly visible.