Client Citizenship Assessment Form
CONTACT INFORMATION
Your Full Legal Name (As shown on your passport)
Address
In which country do you live now?
Contact
PERSONAL INFORMATION
Date of Birth
Place of Birth
In which country were you born?
Citizenship
Marital Status
Select Your Current Status
Never Married
Married
Engaged
Living with your Same Sex Partner [FOR MORE THAN 1 YEAR]
Living with your Common Law Partner [FOR MORE THAN 1 YEAR]
Separated
Divorced
Widowed
YOU FATHER'S PERSONAL INFORMATION
Father's Date of Birth
Father's Place of Birth
In which country was your father born?
Father's Citizenship
YOU MOTHER'S PERSONAL INFORMATION
Mother's Date of Birth
Mother's Place of Birth
In which country was your Mother born?
Mother's Citizenship
YOUR RESIDENCY DETAILS
Are you lawfully admitted to Canada for permanent residence?
YES
NO
How long have you been physically within Canada in the past 5 years?
Please indicate which of the years listed below did you file your income taxes with the CRA?
2025
2024
2023
2022
2021
2020
Please describe what reasons have you left Canada in the past 5 years, and for how long
YOUR ENGLISH LANGUAGE ABILITY
English - Speaking
Select Your English Speaking Ability
Fluent - (can converse without limitation)
Well - (have limited vocabulary but people understand)
With Difficulty
None
English - Reading
Select Your English Reading Ability
Fluent - (can read without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
English - Writing
Select Your English Writing Ability
Fluent - (can write without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
English - Listening/Understanding
Select Your English Listening Ability
Fluent - (can understand without limitation)
Well - (have limited vocabulary but understand most words)
With Difficulty
None
YOUR FRENCH LANGUAGE ABILITY
French - Speaking
Select Your French Speaking Ability
Fluent - (can converse without limitation)
Well - (have limited vocabulary but people understand)
With Difficulty
None
French - Reading
Select Your French Reading Ability
Fluent - (can read without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
French - Writing
Select Your French Writing Ability
Fluent - (can write without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
French - Listening/Understanding
Select Your French Listening Ability
Fluent - (can understand without limitation)
Well - (have limited vocabulary but understand most words)
With Difficulty
None
MISCELLANEOUS
If you or your spouse/partner have any relatives already living in Canada, please provide details
If you or your spouse/partner have been charged with, or convicted of any offense in the last 10 years please provide details, if there are none enter "None".
Thank you for providing your details. We shall respond to you within 5 business days.
The information provided within this assessment is confidential and shall only be shared as necessary, by Candi Immigration staff with Canadian Immigration personnel (IRCC - Immigration, Refugee & Citizenship Canada) for the purposes of a citizenship application, or appeal on behalf of the applicant.
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