eTA Application Form

Personal Details

Last name(s) *

First name(s) *

Date of Birth *

Gender *

Male Female Other

Passport Issuing Country *

Current Country of Residence *

Country of Birth *

City of Birth *

Marital Status *

What travel document do you plan to use to travel to Canada? *

Passport Details

Nationality noted in your passport *

Passport Date of Issue *

Passport Expiry Date *

Passport Number *

Have you previously applied to enter or remain in Canada?*

Yes No

Are you a citizen of any other country?*

Yes No

Please indicate which nationality you also have.

Contact Details

Email Address *

Alternate Email (optional)

Residential Address *

USA Province/state

Canada Province/state

Zip Code/Postal Code

Contact name for billing *

Employment Details

Employment information *

Occupation
Select the option that best describes your current employment situation.

Job Title
Select the option that best describes your job.

Country *

Usa Country/territory *

City *

Start Year *

Consent and declaration

Consent and declaration

Information provided to CIC is collected under the authority of the Immigration and Refugee Protection Act (IRPA) to
determine admissibility to Canada. Information provided may be shared with other Canadian government institutions such
as, but not limited to, the Canada Border Services Agency (CBSA), the Royal Canadian Mounted Police (RCMP), the
Canadian Security Intelligence Service (CSIS), the Department of Foreign Affairs, Trade and Development (DFATD),
Employment and Social Development Canada (ESDC), the Canada Revenue Agency (CRA), provincial and territorial
governments and foreign governments in accordance with subsection 8(2) of the Privacy Act. Information may be
disclosed to foreign governments, law enforcement bodies and detaining authorities with respect to the administration
and enforcement of immigration legislation where such sharing of information may not put the individual and or his/her
family at risk. Information may also be systematically validated by other Canadian government institutions for the
purposes of validating status and identity to administer their programs.

Where biometrics are provided as part of an application, the fingerprints collected will be stored and shared with the
RCMP. The fingerprint record may also be disclosed to law enforcement agencies in Canada in accordance with
subsection 13.11(1) of the Immigration and Refugee Protection Regulations. The information may be used to establish or
verify the identity of a person in order to prevent, investigate or prosecute an offence under any law of Canada or a
province. This information may also be used to establish or verify the identity of an individual whose identity cannot
reasonably be otherwise established or verified because of physical or mental condition. Canada may also share
immigration information related to biometric records with foreign governments with whom Canada has an agreement or
arrangement.

Depending on the type of application made, the information you provided will be stored in one or more Personal
Information Banks (PIB) pursuant to section 10(1) of Canada's Privacy Act. Individuals also have a right to protection and
access to their personal information stored in each corresponding PIB under the Access to Information Act. Further
details on the PIBs pertaining to CIC's line of business and services and the Government of Canada's access to
information and privacy programs are available at the Infosource website (https://infosource.gc.ca) and through the CIC
Call Centre. Infosource is also available at public libraries across Canada.

I declare that the information I have stated in this application is truthful, complete and correct. I understand Terms and Conditions and policies of CANADA eTA Application Services and will not form any objection against the service. I understand that misrepresentation is an offence under section 127 of the Immigration and Refugee Protection Act and may result in a finding of inadmissibility to Canada or removal from Canada. I agree that by typing my name and clicking sign, I am electronically signing my application.
*Remember that if you hold a valid Canadian permanent residence card, you do not need an eTA only the residence card.

Electronic Signature:

If you want to continue submitting your eTA application and agree to all declarations above, please enter your last name down below.
In case an error occurs, please check if you put in the correct last name. Your last name must be the same as the on on the top of the application form.

Date of Signature:2024/11/25/
Applicant Details:

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