Family Sponsorship Free Assessment Form1. QUESTIONS ABOUT THE SPONSOR (CANADIAN CITIZEN OR PERMANENT RESIDENT)A. SPONSOR PERSONAL DETAILSFull Name*GenderMaleFemaleDate of BirthPlace of BirthCitizenshipFull Postal AddressEmail Address*Phone Number*Are you a Canadian citizen?YesNoAre you a Canadian permanent resident?YesNoCountry of Residence*B. WHO DO YOU WANT TO SPONSOR? (CHECK ONE OR MORE)Spouse (husband or wife)Common-law partnerConjugal partnerChildParentGrandparentOrphanAdopted childPlease provide details about who you want to sponsor including the number of people you want to sponsor and their relationship to you and to each other:If you need more information about the types of relatives you can sponsor, please refer to the Family Class page.C. SPONSOR ANNUAL INCOMEAre you employed?YesNoWhat was your total income for the last year in Canadian dollars?Are you married, or do you have a common-law partner?YesNoHow many children under the age of 19 do you have?How many people do you intend to sponsor?What will be your total family size, including yourself, when the person(s) you want to sponsor arrive in Canada?Please provide any important details about your family size and income here:D. SPONSOR ELIGIBILITY DETAILSHave you yourself been sponsored within the past 5 years?YesNoHave you sponsored anyone else within the past 3 years?YesNoAre you subject to a removal order?YesNoAre you detained in any penitentiary, jail, reformatory, or prison?YesNoHave you been convicted of a sexual offence within the past 5 years?YesNoHave you been convicted of a violent crime or a crime that resulted in bodily harm within the past 5 years?YesNoAre you in default of any previous undertaking or any support payments ordered by a court?YesNoAre you an undischarged bankrupt?YesNoAre you in receipt of social assistance for any reason other than a disability?YesNoIf you answered yes to any of the above questions, please provide details here:2. QUESTIONS FOR THE APPLICANT (PERSON TO BE SPONSORED)A. APPLICANT PERSONAL DETAILSFull Name*GenderMaleFemaleDate of BirthPlace of BirthCitizenship*Country of Residence*Full Postal AddressEmail AddressPhone NumberAre you married or do you have a common-law partner?YesNoDo you have any children?YesNoIf yes, how many children do you have and what are their ages?B. APPLICANT ADMISSIBILITYHave you, your spouse, or any of your children had any serious disease or physical or psychological disorder?YesNoBeen convicted of or are currently charged with a criminal offence in any country?YesNoApplied previously for a temporary visa to Canada?YesNoApplied previously for permanent residence in Canada?YesNoBeen refused a visa to Canada or any other country?YesNoBeen refused admission to or order removed from Canada or any other country?YesNoBeen involved in the commission of human rights violations, acts of subversion, espionage, terrorism, or organized criminality?YesNoIf you have replied “yes” to any of the above questions, please provide details:C. FINAL DETAILSIf there is anything else that you believe is important in relation to your case please note it here:DECLARATIONI certify that the above information provided by me in the Free Assessment is true.*Yes, TrueFurthermore, I consent to the law office of Matthew Jeffery, contacting me in relation to the above Free Assessment.*YesSendThis field should be left blank