PROTECTED WHEN COMPLETED - B

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DOCUMENT CHECKLIST
PERMANENT RESIDENCE - HOME CHILD CARE PROVIDER OR HOME
SUPPORT WORKER

This document is available in PDF format only. You need to mail this form and other documents with your application. Please make sure you print this
document, complete it and include it in your application as the cover page.

The checklist of required documents is subject to change. Applicants are advised to refer to the application kit on the IRCC website periodically
while preparing their application to ensure that they have included all forms and documents listed on the most up-to-date checklist.

Gather your documents in the order of the checklist and check R each item. Attach small items such as photos and certified cheques with a paper clip,
otherwise leave documents unbound. Place all documents in a sealed envelope. If your documents are not in English or French, you must include the
English or French translation with a certified copy of the original document, and an affidavit from the person who completed the translation (if the translation
is not provided by a member in good standing of a provincial or territorial organization of translators and interpreters in Canada). Do not send any additional
documents when submitting your application to the Case Processing Centre in Edmonton, Alberta (CPC-E).

Note: If you are unable to provide any of the requested documentation, include with your application, a written explanation with full details
as to why that documentation is unavailable and any documentation that would support your claim. If your application lacks any of the
documents without a reasonable justification, it will be returned to you or in certain circumstances could result in the refusal of your
application.

IMPORTANT NOTICE: Answer all questions and sign all forms where applicable. Please note that by signing these documents, you are certifying that all
information provided therein, whether prepared by you or not, is complete and true in all respects.

If you or someone acting on your behalf directly or indirectly submits false documents or misrepresents facts relating to your application for a permanent
resident visa:

your application may be refused;

the circumstances of your refusal will be entered into Canada's global immigration database; and
you and your family members could become inadmissible to Canada for five years under section 40(2) of the Immigration and Refugee
Protection Act.

The officer will base their decision on the documents on file at the time of the assessment. In the following circumstances, it is your responsibility to notify the
office processing your case and provide the relevant supporting documentation if there are changes in the following:

family status (e.g.: marriage or common-law union, divorce, annulment, legal separation, birth, adoption, death of the principal applicant or any
accompanying family member, including grandchildren born to dependent children);
education (e.g.: completion of another degree); or
mailing address/e-mail address/contact information.

Any changes which we have not been informed of will delay processing or may result in the refusal of the application or the exclusion of a family member.

This form is made available by Immigration, Refugees and Citizenship Canada and is not to be sold to applicants.

(DISPONIBLE EN FRANÇAIS - IMM 5981 F)

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Forms and supporting documents (to be completed by all applicants)

Do not submit originals unless otherwise stated as documents will not be returned.

Original or certified copies of documents or more information may be requested by an officer at a later date. You must keep a copy of the
completed forms and all documents before sending them to IRCC.

FORMS LIST Format R

Generic Application Form to Canada (IMM 0008)
1 Original
Completed, dated and signed by the principal applicant.

Additional Dependants/Declaration (IMM 0008DEP) (if applicable)

2 Completed, dated and signed by the principal applicant if the applicant has more than five dependants (whether they are Original
accompanying or not).

Schedule A: Background/Declaration (IMM 5669)

Completed dated and signed by everyone in the following list:
3 • the principal applicant Original
• spouse or common-law partner (whether they are accompanying or not)
• each dependent child over the age of 18 years (whether they are accompanying or not)

Supplementary Information - Your Travels (IMM 5562)

4 Original
Completed by the principal applicant.

Schedule 19 A: Home Child Care Provider and Home Support Worker Declaration
5 of language and education (IMM0008 - Schedule 19A) Original
Completed, dated and signed by the principal applicant.

Schedule 19 B: Home Child Care Provider and Home Support Worker Declaration
of work experience (IMM0008 - Schedule 19B)
Completed, dated and signed by the principal applicant.

NOTE:
6 Send us this form either: Original
• with your initial application package if you already have at least 24 months of qualifying work experience at the time
of application or,
• subsequent to your initial application, once you have obtained at least 24 months of qualifying work experience on
an occupation restricted open work permit.
Additional Family Information (IMM 5406)
Completed dated and signed by everyone in the following list:
7 • the principal applicant Original
• spouse or common-law partner (whether they are accompanying or not)
• each dependent child over the age of 18 years (whether they are accompanying or not)

Application for Work Permit made outside Canada (IMM 1295) OR if you are in Canada, Application to Change
Conditions, Extend my Stay or Remain in Canada as a Worker (IMM 5710) (if applicable)

8 Completed, dated and signed by the: Original

• the principal applicant (if you do not have the work experience)
• spouse or common-law partner (if accompanying)
• each dependent child over the age of 18 years (if accompanying)

Use of a Representative (IMM 5476)

9 Original
Complete, date, sign and include this form in your application if you have a paid or unpaid representative.

IMM 5983 – Offer of Employment Home Child Care Provider and Home Support Worker Pilots

You don’t need to submit a job offer if you are providing proof of at least 24 months of qualifying Canadian work
experience in a eligible occupation in your application package. If you don’t have the qualifying work experience at the
10 Original
time of application, you are required to provide a job offer.

Your employer should complete this form and provide it to you to submit with your application package. You must read
the declarations and sign the form.

Fee Payment
11
Consult the "pay the fees" section in the instruction guide for further information.

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DOCUMENTS LIST Format R

Travel documents and passports
Passports or travel documents for you, your spouse or common-law partner and your dependent children. Include only
copies of pages showing:
• date of issue and expiry
• photo, name, date and place of birth
12 • pages showing any amendments in name, date of birth, expiration, etc. Copies

Copies of the above pages can be printed images taken of the passport or travel document.
You must hold a valid regular passport. Diplomatic, official, service or public affairs passports are not valid for immigration
to Canada.

Proof of Language Proficiency

For you as the principal applicant, designated language proficiency test results:

English
• IELTS: International English Language Testing System (General Training test only)
• ICELPIP: Canadian English Language Proficiency Index Program (General test only)
13 Copy
French
• TEF Canada: Test d’évaluation de français
• TCF Canada: Test de connaissance du français
Note: Language proficiency test results must indicate that you meet the required proficiency level in English or French
and be less than two years old at the time you apply.

Proof of Work Experience in Canada

When providing proof of qualifying work experience in Canada in an eligible occupation, include:
• a copy of your most recent work permit in Canada;
• employer reference letters for the periods of work experience identified in your application;
• copies of your T4 tax information slips and your Notice of Assessment (NOA) issued by the Canada Revenue
Agency (CRA) for the periods of work experience identified in your application;

If you are unable to provide any of the above, you can provide:
• a sufficient combination of other supporting documentation, which could include copies of a record or letter of
employment from the employer in Canada, work contracts and pay stubs for the periods of work experience identified in
your application.
Copies
Important: when submitting your tax information, be sure to block out your Social Insurance Number (SIN) to protect this (originals may
14 personal information. be requested by
an officer later in
Employer reference letters must include all of the following information:
the process)
• the specific period of your employment (i.e. from/to dates)
• a description of your main responsibilities and duties
• the corresponding National Occupational Classification (NOC) code (if known)
• your total annual salary and benefits
• the number of hours you worked per week
• employer's name and signature, full address, telephone number and e-mail address (if applicable).

Note: send us proof of 24 months of qualifying Canadian work experience in an eligible occupation either:
• with your initial application package if you already have at least 24 months of qualifying work experience or,
• subsequent to your initial application, once you’ve obtained at least 24 months of qualifying work experience on an
occupation restricted work permit.

Proof of Education
For you as the principal applicant:
• proof of a completed Canadian one-year post-secondary educational credential (or higher); OR
• proof of a completed foreign educational credential AND an Educational Credential Assessment (ECA) report Copies,
15 issued by a designated organization indicating the authenticity and equivalency of your completed foreign educational unless otherwise
credential(s) to a completed Canadian one-year post-secondary educational credential (or higher). stated
Note: your ECA report must have been issued on or after the date on which the organization was designated by IRCC
and must be less than five years old at the time you apply.

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DOCUMENTS LIST Format R

Identity and Civil Status Documents
You must provide the following documents for you and your spouse or common-law partner:
• birth certificates;
• legal documents showing name or date of birth changes (if applicable);
• marriage certificate(s), final divorce or annulment certificate(s). If married more than once, include certificates from each
marriage and divorce or annulment you, your spouse or common-law partner have had; Copies,
16 • death certificate for former spouse(s) or common-law partner(s) (if applicable); unless otherwise
• national IDs, family/household registry/book (if applicable); stated
• if you have a common-law partner, complete and include the Statutory Declaration of Common-Law Union
(IMM 5409 – original) and provide evidence that you have cohabitated with your partner for a period of at least
12 continuous months. Provide the following documents listing both your names, for example:
• copies of joint bank account statements,
• copies of leases,
• utility bills, etc.

Proof of your ability to perform the work:

You do not need to submit proof in your application package of your ability to perform the work if you are providing proof
of at least 24 months of qualifying Canadian work experience in an eligible occupation. If you do not have the qualifying
work experience at the time of application, you are required to provide proof of your ability to perform the work described
in the lead statement of the occupational description of the NOC (NOC 4411, if you are applying for the home child care
provider pilot and NOC 4412, if you are applying for the home support work pilot). Copies,
17 unless otherwise
When providing proof of your ability to do the work this includes: stated
• proof of relevant previous work experience (either paid or unpaid), this can include employer reference letter or
employment records, work contract or pay stubs.
• copies of relevant education credentials or training, which can include diplomas or certificates.
• a copy of your most recent work permit in Canada (if you have been working in Canada).

Children's Information (if applicable)

• children's birth certificates (which name their parents);
• adoption papers issued by recognized national authorities showing the legal, approved adoption of adopted dependent
children;
• proof of full custody for children under the age of 18 and proof that the children may be removed from the jurisdiction of
Copies,
the court;
18 unless otherwise
• if the other parent of your children is not accompanying you to Canada, you must submit a signed Statutory
stated
Declaration from Non-Accompanying Parent/Guardian for Minors Immigrating to Canada (IMM 5604 - original).

You must submit one form for each child and a copy of the non-accompanying parent's photo ID showing their signature;
• you must submit proof if the child is 22 years of age or older and depends substantially on the financial support of the
parent since before the age of 22 and is unable to be financially self-supporting due to a physical or mental condition.

Police Certificates and Clearances

If you are required to submit police certificate, you are strongly encouraged to submit them with your application to the
CPC-E. If you are unable to obtain all the necessary police certificates, you may still send your application to the CPC-E
without them. However, we strongly recommend that you take steps to obtain your police certificates now to avoid future
delays. You must be ready to submit them when requested by an officer.
19 Original
Note: Police certificates are generally considered to be valid for one year from date of issue; therefore depending on the
processing time of your application, you may be requested to submit new certificates.
Consult our Web site at: [Link]
police-certificates/[Link] for specific and up-to-date information on how to obtain police certificates from any country or
territory.

Required Photos
Supply two (2) photos for each member of your family, whether accompanying or not, and yourself. Follow the instruction
provided in the section How to Complete the Forms of the application guide and in Appendix A: Photo Specifications.
20 Photos must have been taken within six (6) months before application submission. Original

On the back of one (1) of the photographs, write the name and date of birth of the person who appears in the photo as
well as the date the photo was taken. Leave the other photograph blank.

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MAILING YOUR APPLICATION Format R

Mail your complete application to CPC-E and include:
• this document checklist
• supporting documents required in this checklist, and
21 • 2 self-addressed mailing labels: Original
• one in English or French, and
• one in the official language of your country or territory of residence.
Consult the mailing address section of the instruction guide for specific instructions on mailing your application.

IMM 5981 (07-2020) E