Citizenship and
Immigration Canada
PROTECTED WHEN COMPLETED - B
Citoyenneté et
Immigration Canada
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Client ID
REQUEST TO CORRECT A DATE OF BIRTH FOR CITIZENSHIP
To assist departmental officials in determining whether to change your date of birth, please complete the details below and answer the questions on this form. If
you are a Canadian citizen, you must enter the following information as it appears on your citizenship certificate. If you are not a citizen yet, please complete the
information as it appears on your Immigration Record of Landing (IMM 1000) or on your Confirmation of Permanent Residence (IMM 5292 or IMM 5509) or on
your Permanent Resident Card (PRC).
Surname/Family name
Given name(s)
Date of birth (DD/MM/YYYY)
as it appears on your citizenship certificate OR
1
Date of birth (DD/MM/YYYY) as it appears on your Immigration Record of
Landing or on your Confirmation of Permanent Residence or on your
Permanent Resident Card (PRC)
Number from your IMM 1000 or IMM 5292 or IMM 5509 or from your
Permanent Resident Card (PRC)
Date of landing (DD/MM/YYYY)
from box 45 of your IMM 1000 or IMM 5292 or box 46 or your IMM 5509 or
from your Permanent Resident Card (PRC)
The date of birth you want to appear on your certificate of citizenship.
Please spell out the month (e.g., 01 January 1978)
2
When did you first realize that the date of birth on your immigration or citizenship document was incorrect?
How did you notice the error?
3
What document or source of information caused the error in your date of birth?
4
Why did you accept a document with an incorrect date of birth?
CIT 0464 (02-2006) E
(DISPONIBLE EN FRANÇAIS - CIT 0464 F)
PAGE 2 OF 2
5
If you already have a citizenship certificate, why did you apply for citizenship with an incorrect date of birth?
6
If you entered Canada as a permanent resident (landed immigrant), why did you accept the Immigration Record of Landing or the Confirmation of
Permanent Residence or the Permanent Resident Card (PRC) with an incorrect date of birth?
7
Why did you not apply to correct your date of birth on your Citizenship Certificate or Immigration Record of Landing or Confirmation of Permanent
Residence or Permanent Resident Card (PRC) sooner?
8
What attempts have you made to correct the date of birth in your country of birth?
Signature
of APPLICANT
CIT 0464 (02-2006) E
(YYYY-MM-DD)
Date