Immigration Canada
APPLICATION FOR WORK VISA FOR OFFICE USE ONLY
Office file number (or IMM 1343 Case Label)
FEDERAL SKILLED WORKER CLASS
SIMPLIFIED APPLICATION PROCESS
Date of receipt stamp at post
THIS FORM MUST BE COMPLETED BY THE
PRINCIPAL APPLICANT
Language you prefer for:
Correspondence: English French
You must meet all criteria
at the time you submit your application
Interview: English French Other
1. Your full name (as shown in your passport or travel document) 12. Your residential address (include postal code, city and country)
Family name
Given name(s)
2. Your sex Male Female
Day Month Year
3. Your date of birth 13. Your mailing address, if different from your residential address
4. Your place of birth Town/City
Country
5. Your country
of citizenship All correspondence will go to this address unless you indicate your e-
mail address below, thereby authorizing correspondence, including file
6. Your country and personal information to be provided to the specified e-mail address.
of residence
Day Month Year
14. Your e-mail address, if applicable
Since when?
7. Your native language
15. Your telephone numbers
Country code Area code Number
8. Your height cm OR ft in At home ( ) ( )
Alternative
9. Colour of your eyes ( ) ( )
10. Your current marital status 16. Details from your passport
Never Legally Passport number
Married Widowed
married separated
Annulled
Divorced Common-law
marriage Country of issue
If you are married or in a common-law Day Month Year
relationship, provide the date on which
you were married or entered into the Day Month Year
common-law relationship Date of expiry
11. Have you previously been married ?
No Yes Give the following details for each previous 17. Your identity card number, if applicable
spouse or partner. If you do not have enough
space, provide details on a separate sheet of
paper.
Name of previous
18. Where do you intend to live in Canada?
spouse or partner
City/Town
Day Month Year
Date of birth
Type of relationship Marriage Common-law union 19. Your current occupation
Day Month Year Day Month Year
From to
This form is made available by Immigration Canada and is not to be sold to applicants.
IMM 0008 (05-2006) E
SKILLED WORKER (DISPONIBLE EN FRANÇAIS - IMM 0008 F TRAVAILLEURS QUALIFIÉS)
PAGE 2 OF 3
20. Work in Canada 23. Language (continued) Your
Have you or, if applicable, your accompanying spouse or common-law proficiency in French
partner, previously worked full-time in Canada for at least one year? High Moderate Basic None
Your spouse or Speak
No Yes You
common-law partner
Read
21. Study in Canada
Write
Have you or, if applicable, your accompanying spouse or common-
law partner, previously studied full-time for at least two years at a Listen
post-secondary institution in Canada?
Your spouse or
No Yes You 24. Do you or, if applicable, your accompanying spouse or common-
common-law partner
law partner, have a relative living in Canada who is a citizen or a
22. Education permanent resident of Canada?
How many years of formal education do you have? Your spouse or
No Yes You common-law partner
What is your highest level of completed education?
Relationship Mother or father Grandmother or grandfather
No secondary Bachelor's degree
Secondary Master's degree Daughter or son Granddaughter or grandson
Trade/Apprenticeship Ph D
Sister or brother Aunt or uncle
Non-university certificate/diploma Spouse or
Niece or nephew common-law partner
23. Language
25. Funds
Which is your first official language: English French
Amount of unencumbered transferable and
Which is your second official language: English French available funds you have in Canadian dollars $
Your proficiency in English
High Moderate Basic None
Speak
Read
Write
Listen
26. Your work experience
Starting with your current occupation, list your occupations within the 10 years preceding the date of your application. Give for each the appropriate National
Occupational Classification code (NOC), the number of years of continuous full-time or equivalent part-time experience and a description of your main duties. List
only occupations that fall in Skill Type 0 or Skill Levels A or B of the NOC. Use additional sheets of paper if there is not enough space on the form.
From To
Occupation NOC Years of experience Main duties
M Y M Y
Less than 1 year
1 year but less than 2
2 years but less than 3
3 years but less than 4
4 years or more
Less than 1 year
1 year but less than 2
2 years but less than 3
3 years but less than 4
4 years or more
Less than 1 year
1 year but less than 2
2 years but less than 3
3 years but less than 4
4 years or more
IMM 0008 (05-2006) E
SKILLED WORKER
PAGE 3 OF 3
27. Details of family members
You must provide the following details about each of your family members, whether they will be accompanying you to Canada or not. You must include only your
spouse or common-law partner, if applicable, and all of your dependent children (natural and/or adopted), and those of your spouse or common -law
partner, who are not already permanent residents or citizens of Canada.
If you have more than three family members, photocopy this page before you start completing it. Make sure you have enough copies to fill in details about all your
family members.
FAMILY MEMBER FAMILY MEMBER FAMILY MEMBER
Family name
Given name(s)
Sex Male Female Male Female Male Female
Day Month Year Day Month Year Day Month Year
Date of birth
Place of birth
Town/City
Country
Country of citizenship
Current country of residence
Other countries
with resident status
Marital status (use one of the
categories in question 10)
Relationship to you
Will accompany you to Canada Yes No Yes No Yes No
Passport details
Passport number
Country of issue
Day Month Year Day Month Year Day Month Year
Date of expiry
Identity card number
Native language
Can communicate in English Yes No Yes No Yes No
Can communicate in French Yes No Yes No Yes No
Education
Total number of years
of formal education
Level of education
Current occupation
Height
cm OR ft in cm OR ft in cm OR ft in
Colour of eyes
28. Declaration and signature
D M Y
I declare that the information I have given
is complete, truthful and correct.
Signature of applicant Date
The information you provide on this form is collected under the authority of the Immigration Protection Act and will be used for the purpose of assessing your
application for work Visa & permanent residence in Canada according to the requirements of the Act. It will be retained in Personal Information Bank CIC PPU
042 entitled immigrant Case File identified in Infosource. It may be shared with other organizations in accordance with the consistent use of information under
the Privacy Act. Under the Access to Information Act individuals have the right to protection of and access to their personal information. Details on these matters
are available at [Link] and through the Citizenship and Immigration Call Centre. Infosource is also available in Canadian public libraries.
IMM
Immigration Canada
PROTECTED WHEN COMPLETED - B 5476
USE OF A REPRESENTATIVE (12-2004)
E
A representative is someone who has your permission to conduct business on your behalf with Citizenship and Immigration Canad a (CIC) and Canada
Border Services Agency (CBSA). You may have one representative only. If you appoint an additional representative, the previous representative will
no longer be authorized to conduct business on your behalf and receive information on your case file. In this case, a representative can be appointed
by your Employer.
Your dependent children aged 18 years or older must complete their own copy of this form if they have a representative.
appointing a representative. Complete Sections A, B and D.
I am:
cancelling the appointment of a representative. Complete Section A, C and D.
SECTION A: APPLICANT INFORMATION
1. Your full name
Family name (Surname)
Given name(s)
Day Month Year
2. Your date of birth
3. If you have already submitted your application:
Name of office where the application was submitted
Location of office
Type of application
(permanent residence, extension of study permit, etc.)
4. Your Citizenship and Immigration Canada Identification number (if known)
Client Identification (ID) or
Unique Client Identifier (UCI) number
SECTION B: APPOINTMENT OF REPRESENTATIVE
• I authorize the following individual to serve as my representative and to conduct business on my behalf with Citizenship and Immigration Canada and
Canada Border Services Agency.
• I authorize Citizenship and Immigration Canada and Canada Border Services Agency to release information from my case file and that of my dependent
children under 18 years of age to my representative. This authorization is in accordance with the Privacy Act.
• I am aware that any information which would be subject to exemption, if I had the right of access under the Privacy Act or the Access to Information Act,
will likely not be released.
5. Your representative's full name
Family name (Surname)
Given name(s)
6. Your representative: (choose one)
is UNPAID and is a:
family member or friend
member of a non-governmental or religious organization
member of the Canadian Society of Immigration Consultants, a Canadian provincial or territorial law society, or the Chambre des notaires du Québec.
other
is or will be PAID and is a member in good standing of:
the Canadian Society of Immigration Consultants
(CSIC) Membership ID number
a Canadian provincial or territorial law
society Which province or territory?
Membership ID number
the Chambre des notaires du Québec
Membership ID number
This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants
IMM 5476 (12-2004) E
PAGE 2 OF 2
7. Your representative's contact information
Name of firm or organization (if applicable)
Mailing address
Postal code/ZIP
Telephone number Country code Area code Number
( ) ( )
Fax number Country code Area code Number
( ) ( )
E-mail address (if applicable)
8. Your representative's declaration:
• I declare that the information in Section B is truthful, complete and correct.
• I understand and accept that I am the person appointed by the applicant to conduct business on the applicant or sponsor's behalf with Citizenship and
Immigration Canada and Canada Border Services Agency.
Signature of representative
Day Month Year
Date
SECTION C: CANCEL THE APPOINTMENT OF A REPRESENTATIVE
I withdraw my authorization for this person to serve as my representative, to receive information on my case file and to conduct business on my behalf with
Citizenship and Immigration Canada and Canada Border Services Agency.
9. Your representative's full name
Family name (Surname)
Given name(s)
Name of firm or
organization (if applicable)
SECTION D: YOUR DECLARATION
10.
• I declare that the information I have given is truthful, complete and correct.
• I understand all the foregoing statements, having asked for and obtained an explanation for every point that was not clear to me.
Signature of applicant
Day Month Year
Date
Signature of spouse or common-law partner
(if applicable)
Day Month Year
Date
Warning! It is a serious offence to give false or misleading information on this form.
The information you provide on this form is collected under the authority of the Immigration and Refugee Protection Act and will be used in assessing your
application according to the requirements of the Act. It will be retained in a Personal Information Bank identified in Infosource. It may be shared with other
organizations in accordance with the consistent use of information under the Privacy Act. Under the Privacy Act and the Access to Information Act individuals have
the right to protection of and access to their personal information. Details on these matters are available at [Link] and through the Citizenship and
Immigration Call Centre. Infosource is also available in Canadian public libraries.
