Adult SIMPLIFIED RENEWAL ABROAD Passport Application

for Canadians applying in London or Dublin

GENERAL INFORMATION

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Failure to complete all the required sections of this form will result in your application being refused.

Who May Use This Form?

NOTE: If you cannot answer yes to all of the conditions outlined here, or if this is your first application for a Canadian passport, you must

complete the Adult Passport Application for Canadians (abroad) form PPTC 040.

IMPORTANT—You may use this form to renew a regular passport only if all of these conditions are met:

You were at least 16 years of age at the time of your previous application.

You are submitting a previous regular Canadian passport that:

A. is not damaged, and was never reported lost or stolen;

B. was valid for five (5) years; and

C. if issued in Canada, is valid or expired no more than one year; OR if the Issuing Authority was outside

of Canada, it was issued after April 30, 2006 (see Section J).

The name on this application form is exactly as it appears on page 2 of the submitted passport.

Note: You cannot use this form if the passport contains a married or a common-law partner surname observation and

you wish to have your new passport issued in your married or common-law partner’s surname.

Fees

For Canadians submitting an application abroad—C$100

(includes the passport service fee (C$75) and consular service fee (C$25))

IMPORTANT

Fees are subject to change.

Administrative fees and any applicable interest will be applied to all dishonoured payments.

Every person who requests a passport service must pay the applicable fee.

The passport service fee is non-refundable.

The fee is in Canadian funds and should be converted to local currency. Please note the exchange rate may fluctuate.

Methods of Payment

Please confirm fee and accepted methods of payment with the nearest Canadian government office abroad.

Cash (where accepted),

Debit card (where accepted),

Credit card (where accepted), or

Certified cheque or money order (postal or bank, where accepted), payable to the Canadian Embassy,

High Commission or consulate as the case may be.

Credit Card Information (where accepted)

COMPLETE and submit with your application if you are paying by credit card.

Visa

MasterCard

Other (please specify name):

Name as it appears on card

Card number

Date of expiry

Month Year

AUTHORIZATION—I authorize

Passport Canada to charge

to my credit card.

Signature of cardholder Date

Year Month Day

FOR OFFICIAL

USE ONLY

Authorization number

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PPTC 482A (2011-06) R3P

GENERAL INFORMATION

Where to Apply

Submit your application at the nearest Canadian government

office that provides passport services in the country where

you reside or are visiting.

For the location of the nearest Canadian government office

abroad that provides passport services, visit our website at

www.passportcanada.gc.ca or consult your local telephone directory.

The following are Canadian government offices:

Canadian embassies;

Canadian High Commissions;

Canadian consulates

(except those headed by honorary consuls).

Requirements Checklist

Both pages of the application form must be completed and signed

within the last 12 months.

Two (2) identical passport photos taken within the last 12 months.

Photos do not need to be signed (see Section L).

Previous Canadian passport (see Section J).

Correct fee for your application (see Section B).

If you were born outside of Canada between February 15, 1977,

and April 16, 1981 inclusively, you may be required to submit

further documentation (see Section 3).

You may be required to apply for a passport through the general

application process using form PPTC 040. Additional documents or

information may be requested in support of this application.

Processing Times

For information on current processing times, visit our website at

www.passportcanada.gc.ca or contact us by telephone

(see Section F).

General information is available 24 hours a day, 365 days a year. Specific information is available during regular office hours.

INFORMATION ON PASSPORTS, FEES AND PROCESSING TIMES

Website: www.passportcanada.gc.ca

Passport Canada, toll-free: 1-800-567-6868

Passport Canada, outside continental USA:

819-997-8338

The nearest Canadian government office that provides passport services

(consult your local telephone directory)

TTY (for persons who are deaf or hard of hearing) available 7:30 a.m. to 8 p.m. ET

Toll-free:

1-866-255-7655

Outside Continental USA:

514-283-5197

INFORMATION ON TRAVEL REPORTS, WARNINGS AND REQUIREMENTS

Website: www.travel.gc.ca

To obtain the most recent version of this form, visit our website.

Application forms are available in large print.

Passport application information booklets are available in Braille.

Protection of Information

All personal information provided on this application form is protected and used in accordance with the provisions of the Privacy Act

(Personal Information Bank No. FAI PPU 030). Personal information is collected by Passport Canada under the Canadian Passport Order, to

determine the applicant’s current and ongoing entitlement to a Canadian passport, to administer passport services and to provide information

to the Consular Affairs Bureau of Foreign Affairs and International Trade Canada in the event that the applicant requires assistance while

travelling abroad. All information provided is subject to routine verifications and security queries.

To strengthen the security of the Canadian passport, Passport Canada uses facial recognition technology to convert the applicant’s photo

into a biometric template for comparison with the Passport Canada database of photos. The photo is then incorporated into the passport as a

digital image. Biometric templates are retained for a maximum of 12 years.

Passport Canada uses the services of third parties to receive passport applications submitted in person. Third parties ensure that all

personal information is protected and used in accordance with the provisions of the Privacy Act.

Passport Canada may contact the applicant/passport holder to solicit feedback about passport services.

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PPTC 482A (2011-06) R3P

INSTRUCTIONS

Personal Information

SURNAME AND GIVEN NAMES TO APPEAR IN PASSPORT

Your name must be written exactly as it appears in the previous passport. Your surname (last name) and given names must be

spelled the same and be placed in the same order. If your name has changed, you cannot use this form. You must complete the

Adult Passport Application (abroad) form PPTC 040.

SURNAME (LAST NAME) AT BIRTH/FORMER SURNAME (FORMER LAST NAME)

Complete only if different from the surname (last name) to appear in the passport (for Passport Canada information only–will not

appear in the passport).

MOTHER'S MAIDEN NAME

Indicate your mother's surname (last name) when she was born.

SIGNATURE

You MUST sign your usual signature on BOTH pages.

Your signature in Section 1 will appear in the passport.

Therefore, your signature MUST NOT exceed the inner

limits of the signature box. If the signature touches the

border, it may be rejected and a new signature will be

required which will cause delays.

Previous Canadian Passport

Enclose the most recent Canadian passport issued to you. Ensure you are eligible for simplified renewal. If you are submitting a

passport that shows an issuing authority within Canada, it must be valid or expired no more than one year from the date we receive

this application. If you are submitting a passport that shows an issuing authority outside of Canada, it must have been issued after

April 30, 2006. If you cannot submit the previous passport, you cannot use this form. You must complete the Adult Passport

Application for Canadians (abroad) form PPTC 040, available from any Canadian government office abroad, or at

www.passportcanada.gc.ca.

If your current passport expires more than 12 months from the date you submit your application, provide a written explanation as to

why you are applying at this time. Should Passport Canada not be satisfied that you have a valid reason for applying early, your

application for a new passport may be refused.

A person's name may appear in only one (1) valid Canadian passport.

If you would like the submitted passport returned to you, you must indicate this on the application form (Section 2). Failure to indicate

your choice will result in Passport Canada securely destroying the submitted passport.

IMPORTANT—You must meet the following eligibility criteria to

use this application form:

you can submit a previous Canadian passport that:

was issued to you within the last six (6) years from the

date we receive this application;

OR if the passport was issued outside of Canada, it

must have been issued after April 30, 2006;

was valid for five (5) years;

is not damaged;

was never reported lost or stolen;

the name on this application form is exactly as it appears

on the submitted passport; and

you were at least 16 years of age at the time of your previous

application.

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PPTC 482A (2011-06) R3P

INSTRUCTIONS

Additional Personal Information

Addresses

Indicate “Same as current address” if your address has not changed

in the last two (2) years.

Occupation

State your occupation over the last two (2) years. If you were a

homemaker or retired for the last two (2) years, indicate this on the

form.

References

Provide two (2) references. Friends, co-workers and neighbours may

be used provided they have known you for at least two (2) years.

Relatives may not be used. References do not need to be Canadian

citizens and may reside in any country, provided we can easily

contact them.

Photo Specifications

Note: No signature is required on either of the photos.

Your passport application will be rejected if your photos do not meet the following specifications:

IMAGE INFORMATION

Photos must be taken with uniform lighting and not show

shadows or flash reflection on the face and head. Photos with

shadows on the face or background are unacceptable.

Photos must show a full front view of the face with both edges

of the face showing clearly. The face and shoulders must be

centred in the photo and squared to the camera.

Eyes must be open and clearly visible. Glasses, including tinted

ones with prescription, may be worn as long as the eyes are

clearly visible. Sunglasses are unacceptable.

Facial expression must be neutral (not frowning or smiling)

with the mouth closed.

The image must be clear, sharp and in focus.

Photos must be taken against a plain, uniform, white or

light-coloured background.

Photos must reflect/represent natural skin tones.

The length from chin to crown of head (natural top of head)

must be between 31 mm and 36 mm (1

1/4

in. and 1

7/16

in.).

Hats and other head coverings are not permitted except when

worn for religious or medical reasons and only if the full facial

features are clearly visible.

Black and white or colour photos are acceptable.

Photos must be originals, not taken from any existing photo, and

must have been taken within the last 12 months.

QUANTITY AND FORMAT

Two (2) identical unaltered photos produced from the same film

or from the same electronic file capturing the digital image.

SIZE AND PAPER

The photos must measure 50 mm x 70 mm in size

(2 in. wide x 2

3/4

in. high).

Heavy weight paper is unacceptable.

Photos must be printed on plain, high quality photographic paper.

PHOTOGRAPHER

Photos must be taken by a commercial photographer.

The name of the photographer or studio, the address and the

date the photo was taken (not the date the photo was printed)

must be provided directly on the back of one (1) photo (see

illustration). Photos do not need to be signed.

Frame Height 70 mm (2

3/4

in.)

Min. Face Height

31 mm (1

1/4

in.)

Max. Face Height

36 mm (1

7/16

in.)

Frame Width 50 mm (2 in.)

Photo Co. Ltd.

111 Any Street

Any Town, COUNTRY

Photo taken

Date

Not actual size. Refer to measurements above.

To avoid delays in issuing the passport, use the Requirements Checklist in Section H,

of the General Information and ensure your application is complete.

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PPTC 482A (2011-06) R3P

Adult SIMPLIFIED RENEWAL ABROAD Passport Application

for Canadians applying in London or Dublin

INFORMATION

PROTECTED

WARNING to all applicants—Any false or misleading statement on this form or relating to any document in support of this application, including concealment of any material

fact, may lead to refusal to issue or revocation of a passport and be grounds for criminal prosecution.

Failure to complete all the required sections of this form will result in your application being rejected.

PRINT OR TYPE IN CAPITAL LETTERS using black or dark blue ink.

Personal Information (see Instructions, Section I)

Surname (last name)

Given name(s)

Surname (last name) at birth

Former surname (former last name) Mother's maiden name

Date of birth

Year Month Day

Place of birth

City Country Prov./Ter./State

(if applicable)

Sex

Female

Male

Marital status Eye colour Hair colour Height Weight

Current home address

Number Street Apartment City

Country

Postal code

Mailing address (if different from above)

Number

Street Apartment City

Country

Postal code

Daytime telephone number

Alternate telephone number Email address

DECLARATION—I solemnly declare that I am a Canadian citizen, that the

photos enclosed are a true likeness of me and that all of the statements made

in this application are true. I declare that I have read and understood the

WARNING to all applicants at the top of this page.

Date

Year Month Day

Signed at

City

Country

Void if signature touches border

Signature (see Instructions, section I)

Date of travel

Unknown

Month Day

Previous Canadian Passport (see Instructions, Section J)

Enclose any Canadian passport issued to you in Canada within the last six (6) years from the date we receive this application.

If you cannot submit the previous passport, you cannot use this form. If the passport was issued outside of Canada, it must

have been issued after April 30, 2006.

Would you like the passport returned to you?

No Yes

Canadian Citizenship

To be completed if you were born outside of Canada between February 15, 1977 and April 16, 1981 inclusively.

a) Are you a naturalized Canadian?

(i.e. did you receive

Canadian citizenship following immigration to Canada?)

Yes – Go to page 2 No – Continue to question b)

b) Was one of your parents born in Canada?

Yes – Go to page 2 No – Continue to question c)

c) When was your current certificate of Canadian citizenship issued?

After January 1, 2007

Before January 1, 2007

Submit the certificate with your application (original only).

Complete and submit form PPTC 001 “Proof of Canadian Citizenship–Additional Information”

available at www.passportcanada.gc.ca or at any Canadian government office that provides

passport services.

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PPTC 482 (2011-06) R3P

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Additional Personal Information (see Instructions, Section K)

Note: If insufficient space, attach a separate sheet.

A Addresses in the last two (2) years

Same as current address.

Addresses in the last two (2) years if different from current address.

(Number, Street, Apartment, City, Country)

From

Year Month

From

Year Month

Occupation in the last two (2) years

(if you are a homemaker or retired, indicate this in the “Employer/school or other” column).

In the last two (2) years, my employers were and/or I was attending educational institutions as follows:

Employer/school or other Address Daytime telephone

Field of employment/studies Date (from) Date (to)

References (see Instructions, Section M)

Provide the following information with respect to two (2) persons who are not your relatives and have known you for at least two (2)

years. They may be contacted to confirm your identity.

1. Surname (last name)

Given name(s)

Relationship Address

(Number, Street, Apartment, City, Country)

Daytime telephone number Evening telephone number

Cell number or email address

Has known me for

State number of years

2. Surname (last name) Given name(s)

Relationship Address

(Number, Street, Apartment, City, Country)

Daytime telephone number Evening telephone number Cell number or email address

Has known me for

State number of years

Emergency Contact (optional)

We recommend that you provide the name of someone who would not normally travel with you. This information is helpful if

you have an accident or become ill while travelling outside of Canada.

Surname (last name) Given name(s)

Relationship to applicant Daytime telephone number Evening telephone number Cell number

Address

Number Street Apartment City

Country

Postal code

Declaration of Applicant

DECLARATION—I solemnly declare that the statements made in this application are true.

Signature of applicant

Date

Year Month Day

Signed at

City Country

Fees and Credit Card Information (see General Information, Sections B and C)

To obtain the most recent version of this form, visit our website at www.passportcanada.gc.ca.

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PPTC 482 (2011-06) R3P

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