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PROTECTED WHEN COMPLETED - B

Adult General Passport Application
for Canadians 16 years of age or over applying in Canada or from the USA
Warning: Any false or misleading statement with respect to this application and any supporting document, including
the concealment of any material fact, may result in the refusal to issue a passport, the revocation of a currently valid
passport, or the refusal of passport services, and may be grounds for criminal prosecution. Your application will not be
processed if you fail to complete all of the required sections of this form and/or refuse to consent to the exchange or
disclosure of any personal information required for the delivery of passport services.
Type or print in CAPITAL LETTERS using black or dark blue ink.

1 Personal Information (see Instructions, section H)

Surname (last name)

Given name(s)
Date of travel
Month Day
Surname (last name) at birth
Unknown
Former surname (last name)

Place of birth

City Country Prov./Terr./State (if applicable)

Date of birth Sex Natural eye colour Height (cm/in)
Year Month Day
Female Male
Current home address

Number Street Apartment City Province/Territory/State Postal/ZIP code

Mailing address (if different from current home address)

Number Street Apartment City Province/Territory/State Postal/ZIP code

Telephone (daytime) Telephone (other) Email address

Declaration—I solemnly declare that I am a Canadian citizen, that the Sign within border
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, Immigration,
Refugees and Citizenship Canada, other federal government institutions, Signature (see Instructions, section H)
Government of Canada offices abroad and third party entities as outlined Date Signed at
in the Privacy Notice Statement in the Instructions. Year Month Day
City Province/Territory/State

2 Declaration of Guarantor (see Instructions, section I)

Note: You must complete and sign all three (3) pages of this application form before requesting that your guarantor complete and sign this section.
Surname (last name) in passport Given name(s)

Date of birth Canadian passport number Date of issue Date of expiry

Year Month Day Year Month Day Year Month Day

Relationship to the applicant Telephone (daytime) Telephone (other)

Current home address

Number Street Apartment City Province/Territory/State Postal/ZIP code

Declaration—I solemnly declare that I have known the applicant identified above I have known Signature of guarantor
personally for at least two (2) years. I have signed the back of one (1) photo to the applicant
certify that the image is a true likeness of the applicant. If applicable, I have signed
and dated a copy of each document to support the applicant's identity to confirm for
that I have seen the original(s). 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, Immigration, Refugees and Citizenship Canada, other federal Date Signed at
government institutions, Government of Canada offices abroad and third party Number of Year Month Day
entities as outlined in the Privacy Notice Statement in the Instructions. years City Province/Territory/State
Aussi accessible en français - PPTC 154
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 Read Instructions

3 Previous Canadian Travel Document (see Instructions, section J)

Has a Canadian travel document (passport, certificate of identity or refugee travel document) been issued to you?

Number Date of issue

No Yes (specify) Year Month Day

If the Canadian travel document is still valid, you must include it with your application.
Would you like the previous passport returned to you? If not, it will be securely destroyed by the Passport Program to protect your
personal information.
Yes, please return it to me.
Note: If a valid Canadian travel document has been lost, stolen, damaged or is inaccessible, 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, once reported lost or stolen, is no longer valid. There is an administrative fee for the
replacement of a valid lost or stolen Canadian travel document (see section C).

4 Proof of Canadian Citizenship (see Instructions, section L)

A To be completed if you were born in Canada. Provide one (1) of the documents listed below (original only):
Registration number Date of issue
Birth certificate in Canada
Certificate number Date of issue or Effective date of citizenship
Certificate of Canadian citizenship
B To be completed if you were born outside of Canada.
1) Provide one (1) of the documents listed below (original only):
Certificate of Canadian citizenship Certificate of registration of birth abroad
(issued by the Registrar of Canadian Citizenship)
Certificate of naturalization Certificate of retention of Canadian citizenship
(issued before February 15, 1977)
Certificate number Date of issue or Effective date of citizenship

2) To be completed if you were born outside of Canada between February 15, 1977 and April 16, 1981 inclusive
(you do not need to complete this section if you are presenting a certificate of Canadian citizenship issued after January 1, 2007).
a) Are you a naturalized Canadian, i.e. did you receive Canadian citizenship following immigration to Canada?
Yes – Go to section 5 No – Continue to question b)
b) Was one of your parents born in Canada?
Yes – Go to section 5 No Complete and submit form PPTC 001, Proof of Canadian Citizenship—Additional
Information, available online at Canada.ca/passport.

5 Documents to Support Identity (see Instructions, section K)

Provide the following information. Include signed and dated copies (both sides), or original documents.
Note: The documents provided in this section must not be the proof of Canadian citizenship provided in section 4.
Type of document Document number Date of expiry (if applicable) Your name as it appears on the document
Year Month Day

Type of document Document number Date of expiry (if applicable) Your name as it appears on the document
Year Month Day

Signature of applicant Date

Year Month Day

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6 Period of Validity (see Instructions, section C)

Choose one (1) of the following periods of validity: 5-year or 10-year

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)
From To
Year Month Year Month

1.
From To
Year Month Year Month
2.
B Occupation in the last two (2) years (check all that apply): I was employed (full- or part-time) Ongoing occupation?
I was in school (full- or part-time)
other, e.g. homemaker, unemployed or retired
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)

C Provide your mother's surname (last name) at the time of her birth.
Mother's maiden name

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 two (2) years. 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

Address (Number, Street, Apartment, City, Province/Territory/State, Country, Postal/ZIP code)

Telephone (daytime) Telephone (other) Email address Has known me for

Number of years
2. Surname (last name) Given name(s) Relationship

Address (Number, Street, Apartment, City, Province/Territory/State, Country, Postal/ZIP code)

Telephone (daytime) Telephone (other) Email address Has known me for

Number of years

9 Emergency Contact Information (optional)

We recommend that you provide the name of someone who would not normally travel with you. This information is helpful if
you have an accident or become ill while travelling.
Surname (last name) Given name(s)

Relationship to the applicant Telephone (daytime) Telephone (other) Email address

Current home address

Number Street Apartment City Province/Territory/State Postal/ZIP code

Signature of applicant Date

Year Month Day

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Adult General Passport Application

for Canadians 16 years of age or over applying in Canada or from the USA
Instructions
A Entitlement to a Canadian Passport
Important notice: We recommend that you not finalize your travel plans until you receive the requested passport.
A Canadian passport is the only reliable and universally accepted travel and identification document for Canadians who travel abroad.
Canadian passports are issued to Canadian citizens only and reflect the applicant's identity, as determined by proof of citizenship and
supporting documents.
For Canadians under 16 years of age, use form PPTC 155, Child General Passport Application.
Applicants who were previously issued a Canadian passport may be able to renew their passport using form PPTC 054, Adult Simplified
Renewal Passport Application. To find out if you are eligible, visit Canada.ca/passport.

B Requirements Checklist
All three (3) pages of the application form completed and signed within the last twelve (12) months and certified by the guarantor
Two (2) identical and unaltered passport photos taken within the last six (6) months, one (1) certified by the guarantor
Proof of Canadian citizenship (original only); the document will be returned to you
Document(s) to support identity (original or copies); copies must be signed and dated by your guarantor
Any valid Canadian travel document (passport, certificate of identity or refugee travel document) issued to you
The fee
Note: All documents submitted throughout the passport application process that are in a language other than English or French must be
translated by a certified translator. Additional documents or information may be requested in support of this application.

C Fee and Period of Validity

Where the application is made in Canada and the passport is to be Where the application is made from the USA** or the passport is
delivered in Canada: to be delivered to the USA**:
5-year validity – CAN$120* 5-year validity – CAN$190*
10-year validity – CAN$160* 10-year validity – CAN$260*
*A CAN$25 consular services fee is included in the above-mentioned fee.
**Includes Bermuda, American Samoa, the Midway Islands, Puerto Rico and the US Virgin Islands.
There is a separate, non-refundable CAN$45 administrative fee for the replacement of a valid lost or stolen Canadian travel document.
Methods of payment (Canadian funds only):
Debit card (Interac), Visa Debit, Virtual Visa Debit or other prepaid cards (Visa, MasterCard, American Express) only for in-person
applications submitted by the cardholder. Prepaid debit cards are not accepted;
Credit card and prepaid card (embossed only). If you are applying by mail, see section D; or
Certified cheque or money order (postal or bank) in the exact amount, payable to the Receiver General for Canada.
Important
Every person who requests passport services must pay the applicable fee in the exact amount.
Applicants who cancel their application or are refused a passport are not eligible for a refund of the passport service fee. Only the
consular services fee of CAN$25, applied only to adult applications, is refundable.
The Passport Program, Immigration, Refugees and Citizenship Canada does not accept personal cheques or payment in cash for
applications submitted in Canada.
Administrative fees and applicable interest will be applied to all dishonoured payments.
Fees are subject to change.

D Credit Card Information

If you are applying in person, do not complete this section. If you are applying by mail and paying by credit card, complete and submit this section with your
application.
Card type: Visa MasterCard American Express
Name as it appears on card Card number Date of expiry
Month Year

Name of applicant
For official use only

Authorization—I authorize the Passport Program Signature of cardholder Date

Year Month Day
to charge CAN$ to my credit card.

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E Applying in Person
Canadians can submit an application in Canada at: For Canadians submitting an application from the USA:
a Passport Program regional office; If you require a passport in exceptional circumstances, contact
a participating Canada Post office; or the nearest Government of Canada office. You can find a list
a participating Service Canada Centre. of Government of Canada offices in the USA online at
travel.gc.ca or in your local telephone directory.
For information on service locations, service standards and requirements for expedited services, visit Canada.ca/passport.

F Applying by Mail
Mailed-in applications are processed in Canada.
By mail By courier The original documents that you enclose with your application
Passport Program Passport Program are valuable. We recommend that you use a courier or mail
Gatineau QC K1A 0G3 22 de Varennes Street service that allows you to track your package.
Canada Gatineau QC J8T 8R1
Canada

G Contact Information
General information is available 24 hours a day, 7 days a week. Agents are available Monday to Friday from 7:30 a.m. to 8:00 p.m.
(Eastern Time) in Canada.
The application forms in large print and the passport application instruction booklet in Braille are available upon request only. For more
information or to order these formats, contact the Passport Program.

Information on passports, fees and processing times

Toll-free: 1-800-567-6868 TTY (for people who are Deaf or hard of
Canada.ca/passport
Outside the continental USA: 1-819-997-8338 hearing) Toll-free: 1-866-255-7655

Travel reports, warnings and requirements

travel.gc.ca

H Personal Information
Surname and given name(s) to appear in passport
Write the name to appear in the passport. If you are requesting a passport in a name that is different from the name that appears on the
proof of citizenship, please note the following:
For a change of surname resulting from a relationship, you must provide a marriage or common-law relationship certificate, or a
document demonstrating termination of the relationship.
For a legal change of name, you must provide a birth certificate or citizenship certificate issued in the new name.
Additional documentation will be required to verify your identity as well as the name to appear in the passport (see section K).
Surname (last name) at birth and former surname (last name)
Complete if different from the surname (last name) to appear in the passport (for the Passport Program, Immigration, Refugees and
Citizenship Canada information only; it will not appear in the passport).
Date of birth
If your proof of citizenship 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.
Place of birth
Your place of birth must be provided on the application form. If you do not wish the place of birth to appear in the passport, complete and
submit form PPTC 077, Request for a Canadian passport without place of birth, available online at Canada.ca/passport.
Signature
You must sign your usual signature on all
three (3) pages.

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I 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 18 years of age or over;
hold a 5-year or a 10-year Canadian passport that is valid or has expired within twelve (12) months of the date the Passport Program
receives this application;
have been 16 years of age or over when the application was submitted for the passport identified in section 2 of this application form;
have known you (the applicant) personally for at least two (2) years. To know you personally 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;
provide the requested information contained in the passport issued in his or her name by completing by hand the declaration of
guarantor section of the application form;
be accessible to the Passport Program for verification.
A Canadian passport holder guarantor does not need to reside in the same country as the applicant.
The guarantor must perform the following three (3) tasks free of charge:
1. Complete and sign the section Declaration of Guarantor (section 2). 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 K).
The Passport Program reserves the right to request a new guarantor.
The applicant must not assist the guarantor in performing his or her duties. If your guarantor requires assistance, contact the Passport
Program.
If you have not known an eligible guarantor for at least two (2) years, complete form PPTC 132, Statutory Declaration in Lieu of
Guarantor, available at any Passport Program regional office in Canada or any Government of Canada office in the USA.
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 passport.

J Previous Canadian Travel Document

Enclose any valid Canadian travel document (passport, certificate of identity or refugee travel document) issued to you. If the passport is
valid for more than twelve (12) months from the date the application is submitted, provide a written explanation as to why you are
applying at this time. Should the Passport Program, Immigration, Refugees and Citizenship Canada not be satisfied that you have a
valid reason for applying early, your application for a new passport may be refused.
A person's name may appear in only one (1) valid Canadian travel document.
Note: If a valid Canadian travel document has been lost, stolen, damaged or is inaccessible, 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, once reported lost or stolen, is no longer valid. If found, it must not be used for travel and must be returned
immediately to the Passport Program or if abroad to the nearest Government of Canada office. There is an administrative fee for the
replacement of a valid lost or stolen Canadian travel document (see section C).

K Documents to Support Identity

Documentation provided to support the identity in the passport must include your name, sex, date of birth, signature and photo. One (1)
or more documents, when combined, may be used to fulfill the five (5) criteria stated above.
All documents submitted to support your identity must be valid and must be issued by a federal, provincial or territorial authority (or local
equivalent abroad).
Identification other than the passport needs to be provided if the passport was issued to you before you turned 16 years of age.
Copies are acceptable, provided your guarantor has signed and dated a copy of each document (both sides) confirming that the original
document has been seen. If you are submitting original documents, they will be returned to you.
If you are submitting copies and are using form PPTC 132, Statutory Declaration in Lieu of Guarantor, the same official who signs the
Declaration must also sign and date the copies of the original document (both sides) to indicate that the original document has been
seen.

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L Proof of Canadian Citizenship
Provide one (1) of the documents indicated in section 4 on the application form (original only). It will be returned to you. Additional information
may be requested to confirm your citizenship.
Certificate of birth in Canada
Only official birth documents issued by the vital statistics office for the applicant's province or territory of birth in Canada are accepted. Certain
exceptions may apply. More information is available online at Canada.ca/passport.
Certificate of Canadian citizenship
Commemorative documents of citizenship are not accepted. If you require a certificate of Canadian citizenship, contact:
Immigration, Refugees and Citizenship Canada
Website cic.gc.ca

Toll-free in Canada 1-888-242-2100

TTY in Canada (for people who are Deaf or hard of hearing) 1-888-576-8502, 8:00 a.m. to 4:00 p.m. (Eastern Time)

M Privacy Notice Statement

All personal information provided on this application form is collected by the Passport Program, Immigration, Refugees and Citizenship Canada (IRCC) for
the purpose of determining entitlement of the applicant to a Canadian passport and to provide information to the Consular Operations Bureau of Global
Affairs Canada in the event that the passport holder requires assistance while travelling abroad. In the performance of those services, the personal
information is collected, used and disclosed under the authority of the Canadian Passport Order and in accordance with the Privacy Act and any other
federal laws, regulations and policies applicable to the protection of personal information, as described in Personal Information Bank PPTC PPD 102
(Regular and Official Travel Passports). In the context of the delivery of passport services, IRCC and other federal government institutions or Government
of Canada offices abroad assisting in the delivery of passport services may exchange personal information. In addition, in determining current and ongoing
entitlement and to maintain the integrity of the Passport Program, all personal information collected is subject to verification and security queries to
authenticate identity and citizenship, as well as to identify the existence of grounds for refusal to issue a passport, the revocation of a currently valid
passport or the refusal of passport services. In the same context, the guarantor's personal information is also subject to verification and security queries to
determine whether the individual meets the guarantor requirements. Personal information may be disclosed to third party entities, such as law enforcement
authorities and identity document issuing institutions, for verification and security queries required in the delivery of passport services. Personal information
may also be disclosed by third party entities to IRCC or other federal government institutions or Government of Canada offices abroad for those same
purposes. To strengthen the security of the Canadian passport, IRCC uses facial recognition technology. Also, an electronic chip is inserted into the
booklet. The chip contains, in electronic format, the photo of the bearer and the personal information found on page 2 of the booklet.
IRCC may contact the applicant or passport holder to solicit feedback about passport services.

N Canadian Passport Photo Instructions

You must submit two (2) identical and unaltered photo prints with each passport application. Electronic photos are not acceptable.
The photos must:
be taken in person by a commercial photographer;
be professionally printed on plain, high quality photographic paper
Photo Co. Ltd.
(photos printed at home are not acceptable); 111 Any Street
Any Town, COUNTRY
be clear, sharp and in focus; in colour or black and white;
Maximum Face Height
36 mm (1 7/16 in.)
Minimum Face Height
Frame Height 70 mm (2 3/4 in.)

Photo taken
show a neutral facial expression (no smiling, mouth closed) and
31 mm (1 1/4 in.)

Date
looking straight at the camera, with eyes open and clearly visible;
have uniform lighting—no shadows, glare or flash reflections; I certify this to be a
true likeness of
show a full front view of the face and top of the shoulders squared to (applicant's name)
the camera (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, Guarantor's Signature
facial features and clothing, so that your features appear clearly
against the background;
Frame Width 50 mm (2 in.)
be originals that have not been altered in any way and not taken
from an existing photo; Not actual size (refer to measurements above)
be taken within the last six (6) months from the date the application is
submitted and reflect your current appearance.
The following must appear on the back of one photo
The name and complete address of the photo studio (not a P.O. Box) and the date the photo was taken. The photographer may use a
stamp or handwrite this information (stick-on labels are not acceptable).
The guarantor's signature.
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.
More information is available at Canada.ca/passport.

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