TR 5341726

Shamila Rajkumar (V401432775) Protected B
Application Summary
Group information
Do you want to apply for more than 1 person at the same time? No
Application for a visitor visa
I want to apply for a: visitor visa or super visa
To visit other family who are not listed

Why do you need a visa?
above or friends for less than 6 months
To join the party of the wedding

Tell us more about what you'll do in Canada. Include dates. anniversary which is planned to be held
on 8th July 2023
When will you enter Canada? 2023-07-06
When will you leave Canada? 2023-07-24
Representative
Are you applying on behalf of someone else? No
Travel document of the applicant
Surname/last name Rajkumar
Given name/first name Shamila
Date of birth 1983-11-19
Gender Female
Date modified: 2023-06-02 19:27:58 UTCZ Page 1 of 9

Travel document information of the applicant
What document are you travelling with? Passport
What kind of passport? Regular
Select the country code that matches the one on your passport LKA (Sri Lanka)
What's the nationality on your passport? Sri Lanka
What's your passport or travel document number? N7750148
Confirm your passport or travel document number N7750148
When was the passport issued? 2018-06-14
Date of expiry of the passport 2028-06-14
Are you a lawful permanent resident of the United States with a valid Green Card
No
(alien registration card)?
Have you held a Canadian visitor visa in the past 10 years? No
Do you currently hold a valid U.S. nonimmigrant visa? No
Are you travelling to Canada by air? Yes
Citizenship and places where the applicant has lived
Country or territory where you were born Sri Lanka
City or town where you were born Kokkuvil
Are you a citizen of more than one country or territory ? No
Which country or territory are you a citizen of?
Country/territory of issue Sri Lanka
I am a citizen of this country or territory since birth
From 1983-11-19
National identity document of the applicant
Do you have a valid national identity document? Yes
Document number RH4497660
Confirm your document number RH4497660
Date of issue 2018-08-14
Select the country or territory that issued this document UK - British subject
Names used in the past
Have you used another name in the past? No

Contact information of the applicant
Manually input address

12 Rose gardens
Address
Southall UB1 2XL
England
Is your mailing address the same as your residential address? Yes
List your current country or territory of residence, then add all other countries or territories where you've lived for the past five
years, for more than 6 months.
Country/territory England
Status Permanent resident
From 2018-08-14
This is where I currently live.
Country/territory England
Status Other
Other status detail Spouse Visa
From 2011-12-14
To 2018-08-14
Biometrics (fingerprints and photo) of the applicant
Do we already have your fingerprints and photo (biometrics), and are they still
Yes
valid?
Do you want to give your biometrics again? No

Invitation
Who is inviting you?
Surname/last name Prabakaran
Given name/first name Menaha
Relationship to you Family member

37 Denim Dr
Mailing address
Brampton Ontario L6P 2R3
Canada
Telephone number
Telephone type Cellular
Select telephone number country or territory Canada/US
Telephone number 6472943768
Email address [email protected]
Has someone else also invited you? No
Finances
How much money do you have for your stay in Canada? (In Canadian dollars -
2500
CAD)
Is someone else giving you money for your stay in Canada? No

Information about education, work and other activities
Post-secondary education history
Have you ever studied at a post-secondary school (university, college or

No
vocational school)? You don't need to have completed a degree or diploma.
Work/activities history
Military/police history
Did you serve in any military, militia, civil defence unit, security organization or
No
police force (including non-obligatory service, reserve or voluntary units)?
Give details of all your employment and activities for the past 10 years.
From 2012-09
Ongoing
Work/Activity Sales and service occupations
Customer and information services

Job title
representatives
Company/employer Tesco PLC
Main duties of the job Customer self service

Bulls Brigge Industrial Estate
Address
Southall
England
Travel history
During the past 5 years have you travelled to a country or territory other than the
No
one where you're a citizen or where you live now?
Have you ever stayed in Canada beyond the validity of your status, attended
school in Canada without authorization, or worked without authorization in No
Canada?
Have you ever been refused a visa or permit, denied entry to, or ordered to leave
No
any country or territory?

Medical background questions
Have you had a medical exam performed by an IRCC authorized panel physician
No
(doctor) within the last 12 months?
Do you want to work in one of the following jobs?
health sciences worker

clinical laboratory worker
patient attendant in nursing or geriatric homes
medical student admitted to Canada to attend university
medical elective and physician on short term assignment No
teacher of primary or secondary schools or other teachers of small
children
domestics worker, someone who gives in-home care to children, the
elderly and the disabled
day nursery worker
Medical background questions- Tuberculosis
In the last 2 years, were you diagnosed with tuberculosis? No
In the last 5 years, have you been in close contact with a person with
No
tuberculosis?
Medical background questions
Are you currently receiving dialysis treatment? No
Have you had a drug or alcohol addiction causing you to be a threat to yourself or
No
others, or to be hospitalized?
Have you had a mental health condition causing you to be a threat to yourself or
No
others, or to be hospitalized?
Have you ever been diagnosed with syphilis? No
Family information
What is your current marital status? Married
Date of marriage or start of common-law relationship 2010-03-20
Name of spouse/common-law partner
Given name/first name Rasaiah
Date of birth 1970-03-26
Country or territory of birth Sri Lanka
Present occupation Management occupations
Is their address the same as yours? Yes
Will your spouse/common-law partner accompany you to Canada? Yes

Children
Do you have any biological, adopted or step-children? No
I understand that I am not declaring any natural, adopted or step-children.
Tell us about your parents
I don't know who my parents are.
Language of the applicant
What is your native language or mother tongue? Tamil
Can you communicate in English and/or French? English
What language do you want us to use to contact you? English
Email address of applicant
Email address [email protected]
Confirm your email address [email protected]
Telephone number of the applicant
Telephone type Cellular
Select telephone number country or territory Other
Telephone number +447 763835467
Documents to support your application

Document name Letter of invitation
File name Invitation letter.pdf
Size of the Document 115.00 KB
Date/time uploaded 2023-06-02 19:27:58 UTCZ
Document name Immigration status (proof)
File name BRP-compressed.pdf
Document name National identity document
File name BRP.pdf
Size of the Document 1,073.00 KB
Document name Passport/travel document
File name Passport Profile-part- Shamila.pdf
Document name Funds (proof)
File name StarlingStatement -2023-merged.pdf
Document name Employer letter (current)
File name Employer Letter.pdf
Document name Marriage certificate
File name Marriage Cirtificate.pdf
Size of the Document 1,240.00 KB
Document name Additional documents
File name Passport Profile-part- Rajkumar.pdf

Fees
Fee Quantity Price Total
Visitor visa 1 CAN$100 CAN$100
Total CAN$100
Consent and declaration

Citizenship and Immigration Canada (CIC), or an organization at CIC's request, may want to contact you in the future to ask you about any services you
received from CIC prior to the application process (such as participation in an information forum), during the application process (including the
application process itself as well as orientation or accreditation services), and services received after arriving in Canada (including settlement,
integration and citizenship). CIC will use this information, along with the information provided by other individuals, for research, performance
measurement or evaluation purposes. CIC will not use this information to make any decisions about you personally.
Do you consent to be contacted by CIC, or an organization at CIC's request, in the future? Yes
I consent to the release to Citizenship and Immigration Canada (CIC) and Canada Border Services Agency (CBSA) of all records and information for the
purpose of processing my request that any government authority, including police, judicial and state authorities in all countries in which I have lived may
possess about me. This information will be used to evaluate my suitability for admission to Canada or to remain in Canada pursuant to Canadian
legislation.
I declare that I have answered all questions in this application fully and truthfully.
Signature of Applicant or Parent/Legal Guardian's for a person under 18 years of age.
Given name/first name Shamila
Privacy Notice
Personal information provided on this form is collected and will be used, disclosed, and retained by Immigration, Refugees and Citizenship Canada
(IRCC) under the authority of the Immigration and Refugee Protection Act (IRPA). The personal information provided will be used for the purpose of
processing applications. The personal information provided may be disclosed to other federal government institutions and third parties including law
enforcement bodies, provincial/territorial governments and/or foreign governments for the purpose of validating identity, eligibility and admissibility.
The personal information collected on an application, and other information collected in support of an application, may be used for computer analytics
to support processing of applications and decision making, including your application. Personal information, including from computer analytics, may
also be used for purposes including research, statistics, program and policy evaluation, internal audit, compliance, risk management, strategy
development and reporting.
Where biometrics are provided in support of an application, the fingerprints collected will be stored and shared with the RCMP. The fingerprint record
may also be disclosed to law enforcement agencies in Canada in accordance with subsection 13.11(1) of the Immigration and Refugee Protection
Regulations. The information may be used to establish or verify the identity of a person in order to prevent, investigate, or prosecute an offence under
any law of Canada or a Province. This information may also be used to establish or verify the identity of an individual whose identity cannot reasonably
be otherwise established or verified because of physical or mental condition. Canada may also share immigration information related to biometric
records with foreign governments with whom Canada has an agreement or arrangement.
Failure to complete the form in full may result in a delay or the application not being processed. The Privacy Act gives individuals the right of access to,
protection, and correction of their personal information. Further details are available in Info Source. If you are not satisfied with the manner in which
IRCC handles your personal information, you may exercise your right to file a complaint to the Office of the Privacy Commissioner of Canada. The
collection, use, disclosure and retention of your personal information is further described in IRCC's personal information bank - IRCC PPU 068.

TR 5341726

Uploaded by

Copyright:

Available Formats

TR 5341726

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

TR 5341726

Uploaded by

Copyright:

Available Formats

Shamila Rajkumar (V401432775) Protected B

Application for a visitor visa

I want to apply for a: visitor visa or super visa

To visit other family who are not listed

To join the party of the wedding

When will you enter Canada? 2023-07-06

When will you leave Canada? 2023-07-24

Are you applying on behalf of someone else? No

Travel document of the applicant

Surname/last name Rajkumar

Given name/first name Shamila

Date of birth 1983-11-19

Date modified: 2023-06-02 19:27:58 UTCZ Page 1 of 9

Travel document information of the applicant

What document are you travelling with? Passport

What kind of passport? Regular

What's the nationality on your passport? Sri Lanka

What's your passport or travel document number? N7750148

Confirm your passport or travel document number N7750148

When was the passport issued? 2018-06-14

Date of expiry of the passport 2028-06-14

Have you held a Canadian visitor visa in the past 10 years? No

Do you currently hold a valid U.S. nonimmigrant visa? No

Are you travelling to Canada by air? Yes

Citizenship and places where the applicant has lived

Country or territory where you were born Sri Lanka

City or town where you were born Kokkuvil

Are you a citizen of more than one country or territory ? No

Which country or territory are you a citizen of?

Country/territory of issue Sri Lanka

I am a citizen of this country or territory since birth

National identity document of the applicant

Do you have a valid national identity document? Yes

Document number RH4497660

Confirm your document number RH4497660

Date of issue 2018-08-14

Names used in the past

Have you used another name in the past? No

Date modified: 2023-06-02 19:27:58 UTCZ Page 2 of 9

Contact information of the applicant

Manually input address

Is your mailing address the same as your residential address? Yes

Status Permanent resident

This is where I currently live.

Other status detail Spouse Visa

Biometrics (fingerprints and photo) of the applicant

Do you want to give your biometrics again? No

Date modified: 2023-06-02 19:27:58 UTCZ Page 3 of 9

Who is inviting you?

Surname/last name Prabakaran

Given name/first name Menaha

Relationship to you Family member

Manually input address

Telephone type Cellular

Select telephone number country or territory Canada/US

Telephone number 6472943768

Email address [email protected]

Has someone else also invited you? No

Is someone else giving you money for your stay in Canada? No