Read the step by step instructions on how to complete the form.
Show instructions Hide instructionsThis form must be completed by each person who wants to apply for an extension of their work permit or change conditions of their stay in Canada, including applying for an initial work permit.
Expand all Collapse allYou must answer all the questions on this application form unless indicated otherwise.
Download and fill out the application form on a computer.
You also have the option of saving your form and completing it later.
Note: Completing the form electronically is easier and reduces the risk of errors that can slow down the application process.
In order to help you fill out the application form, read and follow the steps below.
Type your Unique Client Identifier number (UCI).
Note: The UCI or Client ID can be found on your study or work permit under the section “Country of Citizenship”.
Question 2From the list, select the language (English or French) in which you would like to receive your service.
Check the appropriate box or boxes to indicate if you are applying for:
Type your family name (surname) as it appears on your passport or travel document (even if the name is misspelled). Do not use initials.
Note: If you do not have a family name on your passport or travel document, enter all your given names here and leave the given name field blank.
Type all of your given names (first, second, or more) as they appear on your passport or travel document (even if the name is misspelled). Do not use initials.
Note: If you do not have a given name on your passport or travel document, leave this field blank. Do not enter “*”, “Not applicable” or “NA”.
Question 2Check the box to indicate if you ever used any other name. This could include your birth name, maiden name, married name, nickname, etc.
If you checked “Yes”, type any other family name that you have ever used.
If you checked “Yes”, type any other given name (first, second, or more) that you have ever used.
From the list, select your gender (F-Female, M-Male or X-Another gender).
Note: If you choose a gender identifier that is different than what you currently have or have had on your Canadian temporary resident document (visa, electronic travel authorization, work permit, study permit or visitor record), you need to complete the Request for a Change of Sex or Gender Identifier form and send it with your application. If you’ve never had a Canadian temporary resident document but you intend to apply for one and you identify with a gender that is different than what appears on your foreign travel document or passport, you also need to complete the Request for a Change of Sex or Gender Identifier form and send it with your application. No supporting documents are required.
Question 4Indicate your date of birth. If your complete date of birth is unknown, please use “*” (star sign/asterisk) to fill in the spaces for the year, month or day, where applicable.
Type your city or town of birth.
From the list, select your country of birth.
From the list, select your country of citizenship. To be a citizen of a country means that you were either born in that country (in most cases) or have been granted citizenship by that country. If you have dual citizenship, select the country that issued the passport you will be using for this trip.
From the list, select the appropriate information to indicate your immigration status in Canada:
Other: This section must be completed if you selected “Other” as a status.
Provide the dates (From-To) to indicate how long you have had this status.
For out-of-status applicants:
Check the box to indicate whether you have lived in any country other than your country of citizenship or your current country of residence for more than six (6) months in the past five (5) years.
If you checked “Yes”, from the list select the appropriate information to indicate the following:
Note: If you are in a common-law union, you must also complete the Statutory Declaration of Common-law Union (IMM 5409) (opens in a new tab) form and include it with your application. If you are married, you must provide a photocopy of your Marriage license or certificate with your application.
Question 10Check the box to indicate whether you have previously been married or in a common-law relationship. If you checked “Yes”, provide the:
From the list, select whether you are able to communicate in English, French or both:
Check Yes or No to indicate if you have taken a test from a designated testing agency to assess your proficiency in English or French.
Type your valid passport or travel document number exactly as indicated on your document. Make sure there is no space between each number or letter.
From the list, select the name of the country or territory that issued your passport or travel document.
Enter the date your passport or travel document was issued.
Enter the date your passport or travel document will expire.
For this trip – Check Yes or No to tell us if you are using a passport issued by the Ministry of Foreign Affairs in Taiwan that shows your personal identification number.
For this trip – Check Yes or No to tell us if you are using a National Israeli passport.
Check Yes or No to tell us if you have a national identity document.
Enter your national identity document number exactly as shown on the document.
From the list, select the name of the country or territory that issued your national identity document.
Enter the date your national identity document was issued.
Enter the date your national identity document will expire.
Check Yes or No to tell us if you are a lawful permanent resident of the United States with a valid alien registration card (green card).
Enter your valid alien registration card (green card) document number exactly as shown on the document.
Enter when your alien registration card (green card) document will expire.
Indicate your current mailing address (where information should be mailed) by typing the following information:
Note: All correspondence will go to this address unless you indicate your e-mail address.
If you wish to have a representative who can conduct business on your behalf, you must provide their email and mailing address in this section and on the Use of a Representative (IMM 5476) form.
Check the box to indicate whether your residential address (where you live) is the same as your mailing address. If "No", type the following information:
Check the appropriate box to indicate if the telephone number is from Canada/the United States (US) or Other (any other country).
From the list, select the type of telephone:
Type your telephone number including the country code, area/regional codes, etc.
If you have an extension number, write it after your phone number under “Ext.”
Check the appropriate box to indicate if your additional telephone number is from Canada/the United States or Other (any other country).
From the list, select the type of telephone:
Type your telephone number including the country code, area/regional codes, etc.
If you have an extension number, write it after your phone number under “Ext.”
Check the appropriate box to indicate if the facsimile (fax) number is from Canada and United States or Other (any other country).
If applicable, type your facsimile (fax) number, including country code, area/regional codes, etc.
If applicable, type your e-mail address using a format similar to the following: name@provider.net
Note: Please ensure this email address is checked regularly. Any emails sent to you by CIC will end in “@cic.gc.ca”, or “@canada.ca”, or “@international.gc.ca”. Please add these to your “safe senders” list in your email program and check the junk mail folder in case important emails get filtered. If we find that the email address you provided is not functional or no longer exists, we will communicate with you by mail. By indicating your e-mail address, you are hereby authorizing transmission of correspondence including file and personal information to be sent electronically to you at the address provided.
Provide the date and the place where you first entered in Canada
Provide the date and the place of your recent entry to Canada
Provide the document number of your most recent Visitor Record, study or work permit.
Select the type of work permit you want:
Ask your employer if you’re not sure if you should choose
If you choose “Open Work Permit” or “Post-Graduation Work Permit”, leave questions 2 to 8 blank.
Do not select “Other” unless you’re on the list below.
Choose “Other” only if you’re applying to extend your status in Canada to work for a
Your employer must give you an employment contract or an employment letter including the following information:
Your employer does not need to submit an offer of employment through the Employer Portal. This means you don’t need to provide a labour market impact assessment (LMIA) number or offer of employment (LMIA-exempt) number.
If you choose “Other” in question 1a), tell us which of the options listed above applies to you.
Provide the location of your employment in Canada:
Provide the following details about your employment:
Provide the dates of your expected employment in the format provided (From – To).
The dates should match the dates in either the
For example, the “From” and “To” date for a spousal open work permit must match the validity of the principal applicant's permit. For a post-graduation work permit, the validity depends on the program of study completed.
Note: A work permit cannot be issued for a duration that is longer than the validity of your passport
Question 6Type the seven-digit number of your valid labour market impact assessment (LMIA) or the alpha numeric combination of the offer of employment (LMIA-Exempt) number. This number begins with the letter “A” and is followed by seven numbers.
If you are applying for a co-op or post-graduation work permit this is not required.
Provide the following details about your Quebec Acceptance Certificate (CAQ):
Note: As of August 2, 2018, the CAQ no longer has a written expiry date. You must calculate your expiry date based on your intended work start date plus the duration of your CAQ. For example, if you intend to start working on January 1, 2019 and your CAQ is valid for 24 months, enter December 31, 2020 for the expiry date.
If you are applying for a co-op or post-graduation work permit this is not required
Select “Yes” if you have been issued a certificate under the Provincial Nominee program. Otherwise, select “No”.
Check the box to indicate if you have any post-secondary education (including university, college or apprenticeship training).
The following table provides examples of post-secondary education:
Training completed in a specific trade, such as carpentry or auto mechanics.
Non-university certificate / diploma
Training in a profession that requires formal education but not at the university level (for example, dental technician or engineering technician).
Academic degree awarded by a college or university to those who completed an undergraduate curriculum; also called a baccalaureate. Examples include a Bachelor of Arts, Science or Education.
Academic degree awarded by a graduate school of a college or university. You must have completed a Bachelor’s degree before a Master’s degree can be earned.
Highest university degree, usually based on at least three years of graduate studies and a thesis. Normally, you must have completed a Master’s degree before a PhD can be earned.
If you checked “Yes”, provide full details of your highest level of post-secondary education:
For co-op and post-graduation work permit applicants: information in this section are not required.
Provide the following information about your employment for the last 10 years. If you are retired, provide the 10 years before your retirement.
Provide details about your current Activity / Occupation:
Provide details of your previous Activity / Occupation for the past 10 years. If you are retired, provide the 10 years before your retirement:
Note: If you need more space, print out an additional page of the form, complete this section and submit it with your application.
All questions in this section must be answered or the application will be considered incomplete and will be returned.
Check the box to indicate if:
Check the box to indicate if you have ever:
Check “Yes” or “No” to indicate if you have ever been a member or associated with any political party, or other group or organization which has engaged in or advocated violence as means to achieving a political or religious objective, or which has been associated with criminal activity at any time.
Check “Yes” or “No” to indicate if you have ever witnessed or participated in the ill treatment of prisoners or civilians, looting or desecration of religious buildings.
