Permanent Resident Card Renewal Assessment FormA. PERSONAL DETAILSFamily Name*Given Name*GenderMaleFemaleFull Postal AddressPhone Number*Email Address*Confirm Email Address*Alternate Email Address*Place of BirthDate of BirthCitizenship*Marital StatusNumber of ChildrenPlace of EmploymentEmployment Position Are you a permanent resident of Canada?YesNoWhen did you obtain permanent residence?Are you currently living in Canada?YesNoWhere do you currently reside?When is the last time you were in Canada?Have you physically resided in Canada for at least 2 years in the past 5 years?YesNoHow many days have you been in Canada in the last 5 years?Have you been working outside of Canada for a Canadian company?YesNo Please provide details.Have you been living with a Canadian citizen spouse or partner outside of Canada?YesNoWhat periods of time have you been living with your Canadian spouse or partner outside Canada?Please explain any Humanitarian and Compassionate grounds that exist in your case explaining why you have not been able to live in Canada.B. APPLICANT ADMISSIBILITYAre you currently under a removal order?Are you currently appealing a negative residency determination?Has your Canadian permanent residence been revoked?If you have replied “yes” to any of the above questions, please provide details.E. FINAL DETAILSIf there is anything else that you believe is important in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, Barrister & Solicitor, contacting me in relation to the above Free Assessment.*YesSendThis field should be left blank