Empresas
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Publicado: 16 de febrero de 2013
Fillable Form
Citizenship and
Immigration Canada
PROTECTED WHEN COMPLETED - A
Citoyenneté et
Immigration Canada
PAGE 1 OF 1
STATUTORY DECLARATION OF COMMON-LAW UNION
BEFORE YOU START,READ THE INSTRUCTION GUIDE. TYPE or PRINT in black ink.
(IF APPLICABLE)
Country
Province/State/Territory
In the matter of an application made pursuant to the Immigration and RefugeeProtection Act and Regulations and in the matter of common-law union,
We,
and
of
(name of declarant)
(name of declarant's partner)
, county of
in
(name of city, town, village)
inthe country of
(if applicable)
(name of province, state, territory)
, solemnly declare that we have cohabited in a conjugal relationship for
continuous year(s) from
(name of country)to
Year
1
Month
Day
.
Year
Month
Day
My common-law partner and I:
a) Have jointly signed a residential
lease, mortgage or purchase
agreement relating to a
residence in whichwe both live.
No
Yes
No
I have life insurance on myself which names
my common-law partner as beneficiary.
Yes
No
Yes
2
c) Have joint bank, trust, credit
union or charge cardaccounts.
b) Jointly own property other than
our residence.
Yes
3
d) Have declared our common-law
union under the Canadian
Income Tax Act. (T-1 "General Individual Income Tax Return")No
My common-law partner has life insurance on
him/herself which names me as beneficiary.
Yes
No
Yes
No
4
If none of the above sections applies, what other documentary evidencedo you have that would indicate your relationship as common-law partners?
5
SOLEMN DECLARATION
We make this solemn declaration conscientiously believing it to be true, and knowing that it is ofthe same force and effect as if made under oath.
Name of declarant
Signature of declarant
Name of declarant's partner
Signature of declarant's partner
Declared before me at (City, Town,...
Citizenship and
Immigration Canada
PROTECTED WHEN COMPLETED - A
Citoyenneté et
Immigration Canada
PAGE 1 OF 1
STATUTORY DECLARATION OF COMMON-LAW UNION
BEFORE YOU START,READ THE INSTRUCTION GUIDE. TYPE or PRINT in black ink.
(IF APPLICABLE)
Country
Province/State/Territory
In the matter of an application made pursuant to the Immigration and RefugeeProtection Act and Regulations and in the matter of common-law union,
We,
and
of
(name of declarant)
(name of declarant's partner)
, county of
in
(name of city, town, village)
inthe country of
(if applicable)
(name of province, state, territory)
, solemnly declare that we have cohabited in a conjugal relationship for
continuous year(s) from
(name of country)to
Year
1
Month
Day
.
Year
Month
Day
My common-law partner and I:
a) Have jointly signed a residential
lease, mortgage or purchase
agreement relating to a
residence in whichwe both live.
No
Yes
No
I have life insurance on myself which names
my common-law partner as beneficiary.
Yes
No
Yes
2
c) Have joint bank, trust, credit
union or charge cardaccounts.
b) Jointly own property other than
our residence.
Yes
3
d) Have declared our common-law
union under the Canadian
Income Tax Act. (T-1 "General Individual Income Tax Return")No
My common-law partner has life insurance on
him/herself which names me as beneficiary.
Yes
No
Yes
No
4
If none of the above sections applies, what other documentary evidencedo you have that would indicate your relationship as common-law partners?
5
SOLEMN DECLARATION
We make this solemn declaration conscientiously believing it to be true, and knowing that it is ofthe same force and effect as if made under oath.
Name of declarant
Signature of declarant
Name of declarant's partner
Signature of declarant's partner
Declared before me at (City, Town,...
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