IMM 5373E : Undertaking/Application to Sponsor - Undertaking to

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<p>Please wait... If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document. You can upgrade to the latest version of Adobe Reader for Windows, Mac, or Linux by visiting For more assistance with Adobe Reader visit Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other countries.</p> <p>Contact Information</p> <p>PROTECTED WHEN COMPLETED -B</p> <p>PAGE OF</p> <p>SPONSORSHIP UNDERTAKING - SPONSORSHIP AGREEMENT HOLDERS (SAH)</p> <p>(DISPONIBLE EN FRANAIS - IMM 5373 F)</p> <p>L:\FormData\Graphics\LiveCycle\200.gif</p> <p>Canada Wordmark</p> <p>Immigration, Refugees and Citizenship Canada</p> <p>L:\FormData\Graphics\FIP_Red\fip-e_RGB.jpg</p> <p>PAGE OF</p> <p>A - SPONSORSHIP AGREEMENT HOLDER INFORMATION</p> <p>B CONSTITUENT GROUP INFORMATION</p> <p>Do you have a Constituent Group?</p> <p>CONSTITUENT GROUP</p> <p>C - CO-SPONSOR INFORMATION</p> <p>If adding a co-sponsor, first identify if they are an individual or an organization.</p> <p>Do you have a Co-sponsor?</p> <p>CO-SPONSOR (INDIVIDUAL)</p> <p>CO-SPONSOR (ORGANIZATION)</p> <p>D - REFUGEE APPLICANT(S) -Include both accompanying and non-accompanying family members. Refer to theGuide for Sponsorship Agreement Holders to privately sponsor refugees(IMM 5413) for definition of family members.</p> <p> Sex</p> <p>Do you have additional family members to add?</p> <p> Sex</p> <p>Do you wish to provide separate contact information for this family member?</p> <p>CONTACT INFORMATION</p> <p>CONTACT INFORMATION</p> <p>Contact Information</p> <p>0,0,0</p> <p>bold</p> <p>setFocus</p> <p>1</p> <p>Current mailing address</p> <p>- All correspondence will go to this address unless you indicate your e-mail address below.</p> <p>- Indicating an e-mail address will authorize all correspondence, including file and personal information, to be sent to the e-mail address you specify.</p> <p>Residential address</p> <p>Same as mailing address?</p> <p>Question 2 Is your residential address the same as your mailing address?</p> <p>-Contact Information-2. Residential Address: Same as mailing address?</p> <p>2</p> <p>Telephone no.</p> <p>3</p> <p>( )</p> <p>Alternate Telephone no.</p> <p>4</p> <p>x</p> <p>( )</p> <p>Fax no.</p> <p>x</p> <p>( )</p> <p>5</p> <p>6</p> <p>E - LINKED / MULTIPLE SPONSORSHIP APPLICATIONS List any linked Sponsorship Applications that should be processed together with this Application</p> <p>Family name and given name(s) of other Principal Applicants linked to this Sponsorship Undertaking</p> <p>Date of birth </p> <p>Application number, if known</p> <p>F OBLIGATIONS, CONSENTS AND DECLARATIONS</p> <p>This Sponsorship Undertaking specifies the obligations of the sponsoring group with respect to the Principal Applicant and all accompanying or non-accompanying family members, including any family members born after this Sponsorship Undertaking is received by Immigration, Refugees and Citizenship Canada (IRCC).</p> <p> Reception - Meet the refugee(s) upon arrival in the expected community of settlement;</p> <p> Lodging - Provide suitable shelter, basic furniture and other household essentials;</p> <p> Care - Food, clothing, local transportation and other basic necessities of life; and</p> <p> Settlement Assistance and Support - Assist the refugee(s) to learn an official language, seek employment, encourage and assist them to adjust to life</p> <p> in Canada, as outlined in the Settlement Plan.</p> <p>We understand that, as signatories to this Sponsorship Undertaking, we are jointly and severally or solidarily bound with the other signatories to:</p> <p> perform the obligations of the Sponsorship Undertaking;</p> <p> assume liability with the other signatories to this Sponsorship Undertaking for any breach of those obligations, with such obligations commencing upon arrival of the</p> <p> refugee(s) in Canada; and</p> <p> support the refugees for 12 months from the date of arrival or until they become self-sufficient, whichever comes first.</p> <p>As per subsection 140.2(1) of theImmigration and Refugee Protection Regulations:</p> <p>If we, as the sponsoring group are submitting the Sponsorship Application package to IRCC, we understand that we are prohibited from using or disclosing any personal information provided to us by the Principal Applicant for the purpose of submitting their Application for Permanent Residence. We agree not to further disclose or use the information for any purpose other than this Sponsorship Application.</p> <p>Alternatively, if the Sponsorship Application package is being submitted to IRCC by the Principal Applicant, we authorize IRCC to collect the personal information in our Sponsorship Undertaking from the Principal Applicant. We understand this information is being collected indirectly for the purposes of processing the Sponsorship Undertaking and for assisting IRCC in assessing and processing the Application for Permanent Residence submitted by the Principal Applicant.</p> <p>We declare that:</p> <p> the information provided is to the best of our knowledge true, complete and accurate;</p> <p> we are not in default of any other Sponsorship Undertakings;</p> <p> we are not in default of any Immigration Loans;</p> <p> we have made or will make adequate arrangements in the expected community of settlement for the reception and settlement of the refugee(s) identified in this</p> <p> Sponsorship Undertaking, as evidenced in the Settlement Plan;</p> <p> we have sufficient financial resources and expertise to fulfill this Sponsorship Undertaking;</p> <p> we have not accepted any funds from the refugee(s) we are sponsoring and will not require the refugee(s) to repay any cost of sponsorship. We understand that any</p> <p> sponsor who attempts to secure or does accept such funds will be considered by IRCC to be in default of this Sponsorship Undertaking; and</p> <p> to the best of our ability, we will not knowingly or deliberately allow any individual to participate in the group's settlement activities who may be considered a threat to</p> <p> the safety and security of the refugee(s).</p> <p>We understand that any false statements or concealment of any material fact may result in, but is not limited to, the following consequences:</p> <p> refusal to approve this or future Sponsorship Undertakings;</p> <p> refusal of the refugee's Application for Permanent Residence;</p> <p> vacation of the the Principal Applicants refugee status;</p> <p> revocation of existing Sponsorship Applications with IRCC; and</p> <p> Prosecution or other enforcement actions.</p> <p>We understand that the Sponsorship Undertaking constitutes a financial obligation that could result in collection action, should there be a breach of that obligation. We understand that any breach of our sponsorship obligations will result in default, and that any provincial social assistance or federal government funds paid to the refugee(s) as a result of sponsorship default becomes a debt owed by us to the federal and/or provincial government. As a result, the federal and/or concerned provincial government have a right to take enforcement action against any signatories to the Sponsorship Undertaking or the sponsoring group as a whole.</p> <p>We understand that signatories to the Sponsorship Undertaking will not be allowed to sign or co-sign an additional Sponsorship Undertaking to sponsor another person under theImmigration and Refugee Protection Act and its Regulations if that signatory or the sponsoring group as a whole is in default of any Sponsorship Undertaking.</p> <p>We consent to IRCC providing our contact information to the government-funded Refugee Sponsorship Training Program (RSTP) for the purpose of receiving information and training on settlement planning to help us prepare for the arrival of the refugee(s) we have applied to sponsor.</p> <p>G - SIGNATURES </p> <p>SIGNATURES FOR COMUNITY SPONSORS</p> <p>Signature</p> <p>Signature</p> <p>SIGNATURES FOR CO-SPONSORS</p> <p>Signature</p> <p>The information you provided on this form is collected under the authority of theImmigration and Refugee Protection Act and will be used to maintain a record of applications and Sponsorship Undertakings by private sponsors in Canada according to the requirements of the Act. It will be retained in the Personal Information Bank CIC PPU 008 identified in Infosource. It may be shared with other organizations in accordance with the consistent use of information under thePrivacy Act. Under thePrivacy Actand theAccess to Information Act, individuals have the right to protection of and access to their personal information. Details on these matters are available and through the Immigration, Refugee and Citizenship Canada Call Centre.Infosource is also available at Public Libraries in Canada.</p> <p>Immigration, Refugees and Citizenship Canada</p> <p>Immigration, Refugees and Citizenship Canada</p> <p>Immigration, Refugees and Citizenship Canada</p> <p>IMM 5373 E : SPONSORSHIP UNDERTAKING SPONSORSHIP AGREEMENT HOLDERS (SAH)</p> <p></p> <p>10-2018</p> <p>E</p> <p>1</p> <p>3</p> <p>2</p> <p>3</p> <p>3</p> <p>3</p> <p>SaveButton1: ResetButton1: PrintButton1: CurrentPage: PageCount: formNum: IMM 5373 (10-2018) ESaveButton2: ResetButton2: PrintButton2: SAH_or_CG: textField: nameofCSO: othername: givenname: address: apt: city: province: postcode: homephone: businessphone: email: yes: no: InsertSubformButton1: RemoveSubformButton1: detail: 1nameCG: nameCGAuthority: givename: Enter the date as YYYY-MM-DD, or click the down arrow to open the calendar. : prov: Please enter the 10 digit phone number. The number will be displayed as: (XXX) XXX-XXXX.: cospon: cosponsor1: 3CEOname: DOB1: websitelink: applicantname: Male: Female: Enter the date as YYYY-MM-DD, or click the down arrow to open the calendar. : country: marital: citizencountry: maritalstat: relation: Accompanying: Non-accompanying: relation2: Yes: No: POBox: AptUnit: StreetNum: Streetname: CityTown: Country: ProvinceState: PostalCode: District: Type: CanadaUS: Other: NumberExt: NumberCountry: ActualNumber: AreaCode: FirstThree: LastFive: IntlNumber: Email: MemberCategories: NumberOfMembers: CSP: Enter as YYYY-MM-DD, or click the down arrow to open the calendar. : CSSA: </p>