Client Information Form

Your Basic Information

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Your First Name
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Your Email Address
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Current Citizenship
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Your Last Name
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  • Mexico
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  • Moldova
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- select your country -
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Your Secondary number
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Birthdate
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  • Gender
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  • Female
  • Other
Gender
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Number of Children
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Spouse's ( Husband, Wife or Common-Law Partner ) Personal Details (if Applicable)

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Family Name
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  • Gender
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  • Female
Gender
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Given Name
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Birthdate
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Place of Birth

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  • Country
  • Åland Islands
  • Afghanistan
  • Albania
  • Algeria
  • American Samoa (US)
  • Andorra
  • Angola
  • Antigua and Barbuda
  • Argentina
  • Armenia
  • Australia
  • Austria
  • Azerbaijan
  • Bahamas
  • Bahrain
  • Bangladesh
  • Barbados
  • Belarus
  • Belgium
  • Belize
  • Benin
  • Bermuda (UK)
  • Bhutan
  • Bolivia
  • Bosnia and Herzegovina
  • Botswana
  • Brazil
  • Brunei
  • Bulgaria
  • Burkina Faso
  • Burma (Myanmar)
  • Burundi
  • Cambodia
  • Cameroon
  • Canada
  • Cape Verde
  • Central African Republic
  • Chad
  • Chile
  • China
  • Colombia
  • Comoros
  • Congo, Democratic Republic of the
  • Congo, Republic of the
  • Cook Islands (NZ)
  • Costa Rica
  • Croatia
  • Cuba
  • Cyprus
  • Czech Republic
  • Denmark
  • Djibouti
  • Dominica
  • Dominican Republic
  • East Timor (Timor-Leste)
  • Ecuador
  • Egypt
  • El Salvador
  • Equatorial Guinea
  • Eritrea
  • Estonia
  • Ethiopia
  • Falkland Islands (UK)
  • Faroe Islands (Denmark)
  • Fiji
  • Finland
  • France
  • French Guiana
  • French Polynesia (France)
  • Gabon
  • Gambia
  • Georgia
  • Germany
  • Ghana
  • Gibraltar (UK)
  • Greece
  • Greenland (Denmark)
  • Grenada
  • Guam (US)
  • Guatemala
  • Guernsey (UK)
  • Guinea
  • Guinea-Bissau
  • Guyana
  • Haiti
  • Honduras
  • Hong Kong (China)
  • Hungary
  • Iceland
  • India
  • Indonesia
  • Iran
  • Iraq
  • Ireland
  • Isle of Man (UK)
  • Israel
  • Italy
  • Ivory Coast
  • Jamaica
  • Japan
  • Jersey (UK)
  • Jordan
  • Kazakhstan
  • Kenya
  • Kiribati
  • Korea, North
  • Korea, South
  • Kosovo
  • Kuwait
  • Kyrgyzstan
  • Laos
  • Latvia
  • Lebanon
  • Lesotho
  • Liberia
  • Libya
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Macau (China)
  • Macedonia
  • Madagascar
  • Malawi
  • Malaysia
  • Maldives
  • Mali
  • Malta
  • Marshall Islands
  • Mauritania
  • Mauritius
  • Mayotte (France)
  • Mexico
  • Micronesia, Federated States of
  • Moldova
  • Monaco
  • Mongolia
  • Montenegro
  • Morocco
  • Mozambique
  • Namibia
  • Nauru
  • Nepal
  • Netherlands
  • New Caledonia (France)
  • New Zealand
  • Nicaragua
  • Niger
  • Nigeria
  • Niue (NZ)
  • Norfolk Island (Australia)
  • Northern Mariana Islands (US)
  • Norway
  • Oman
  • Pakistan
  • Palau
  • Palestinian territories
  • Panama
  • Papua New Guinea
  • Paraguay
  • Peru
  • Philippines
  • Pitcairn Islands (UK)
  • Poland
  • Portugal
  • Qatar
  • Réunion (France)
  • Romania
  • Russian Federation
  • Rwanda
  • São Tomé and Príncipe
  • Saint Helena, Ascension and Tristan da Cunha (UK)
  • Saint Kitts and Nevis
  • Saint Lucia
  • Saint Pierre and Miquelon (France)
  • Saint Vincent and the Grenadines
  • Samoa
  • San Marino
  • Saudi Arabia
  • Senegal
  • Serbia
  • Seychelles
  • Sierra Leone
  • Singapore
  • Slovakia
  • Slovenia
  • Solomon Islands
  • Somalia
  • South Africa
  • South Sudan
  • Spain
  • Sri Lanka
  • Sudan
  • Suriname
  • Svalbard and Jan Mayen (Norway)
  • Swaziland
  • Sweden
  • Switzerland
  • Syria
  • Taiwan
  • Tajikistan
  • Tanzania
  • Thailand
  • Togo
  • Tokelau (NZ)
  • Tonga
  • Trinidad and Tobago
  • Tunisia
  • Turkey
  • Turkmenistan
  • Tuvalu
  • Uganda
  • Ukraine
  • United Arab Emirates
  • United Kingdom
  • United States
  • Uruguay
  • Uzbekistan
  • Vanuatu
  • Vatican City
  • Venezuela
  • Vietnam
  • Wallis and Futuna (France)
  • Western Sahara
  • Yemen
  • Zambia
  • Zimbabwe
Country
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Citizenship
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City
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Country of Residence
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Net Worth

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Your personal net worth is the current value of all the assets (e.g. properties, investments, stocks, bonds, bank accounts) that you (and your spouse/common-law partner, if applicable) personally own, MINUS the current value of all your combined personal liabilities (e.g. mortgages, loans, credit card balances). Please be sure to include your share of the value of any businesses that you own

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What is your monetary net worth in Canadian dollars, including your assets and the assets of your spouse?
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Business Experience

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Your management experience may have been gained in a private or public business, international agency, government or government department, professional practice, or farming.


During any two of the last five years:

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  • Do you have management experience?
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  • No
Do you have management experience?
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  • Have you owned a business?
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  • No
Have you owned a business?
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DESCRIPTION OF BUSINESS

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Please provide a description of your business activities
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BUSINESS PLAN IN CANADA

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If you intend to start a business in Canada, please indicate what type of business you intend to start, together with any other details you believe are relevant
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Is there any specific city or province in Canada that you wish to settle in?*
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EDUCATION

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Your total number of years of full-time education
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  • Level of Education Achieved
  • Secondary school
  • 1 year post-secondary credential
  • 2 year post-secondary credential
  • 3 year post-secondary credential
  • Two or more post-secondary credentials
  • University credentials at the master's or professional level
  • University credential at the doctoral level
Level of Education Achieved
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LANGUAGE ABILITY

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ENGLISH

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  • Read
  • None
  • Basic
  • Well
  • Fluently
Read
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  • Speak
  • None
  • Basic
  • Well
  • Fluently
Speak
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  • Listen (oral comprehension)
  • None
  • Basic
  • Well
  • Fluently
Listen (oral comprehension)
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  • Write
  • None
  • Basic
  • Well
  • Fluently
Write
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FRENCH

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  • Read
  • None
  • Basic
  • Well
  • Fluently
Read
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  • Speak
  • None
  • Basic
  • Well
  • Fluently
Speak
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  • listen (oral comprehension)
  • None
  • Basic
  • Well
  • Fluently
listen (oral comprehension)
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  • Write
  • None
  • Basic
  • Well
  • Fluently
Write
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EXPLORATORY VISIT

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  • Have you every made an exploratory business visit to Canada?
  • Yes
  • No
Have you every made an exploratory business visit to Canada?
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ADMISSIBILITY

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  • Have you, your spouse, or any of your children had any serious disease or physical or psychological disorder?
  • Yes
  • No
Have you, your spouse, or any of your children had any serious disease or physical or psychological disorder?
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  • Applied previously for a temporary visa to Canada?
  • Yes
  • No
Applied previously for a temporary visa to Canada?
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  • Been refused a visa to Canada or any other country?
  • Yes
  • No
Been refused a visa to Canada or any other country?
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  • Been involved in the commission of human rights violations, acts of subversion, espionage, terrorism, or organized criminality?
  • Yes
  • No
Been involved in the commission of human rights violations, acts of subversion, espionage, terrorism, or organized criminality?
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  • Been convicted of or are currently charged with a criminal offence in any country?
  • Yes
  • No
Been convicted of or are currently charged with a criminal offence in any country?
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  • Applied previously for permanent residence in Canada?
  • Yes
  • No
Applied previously for permanent residence in Canada?
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  • Been refused admission to or order removed from Canada or any other country?*
  • Yes
  • No
Been refused admission to or order removed from Canada or any other country?*
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If you have replied “yes” to any of the above questions, please provide details*
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FINAL DETAILS

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If there is anything else that you believe is important in relation to your qualifications please note it here.
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DECLARATION

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Furthermore,*

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