Passport- Canada (Personal Information Form)
Important notice: We recommend that you not finalize your travel plans until you receive the requested passport.

This form is to advise Visa And More that you are requesting the Passport documentation. In order to properly process your request, please submit this form and submit your other documents as per the check list. The applicant do solemnly and sincerely declare that the particulars stated here are true, and the applicant make this solemn declaration conscientiously believing the same to be true.

Visa And More Concierge Service provides you a Concierge Specialist to manage the entire application process including document preparation and review, upgraded shipping, priority submission and more beginning within 4 business hours of your request. It's a complicated world out there. Let us simplify it for you.

From start to finish, you are assigned a Concierge Specialist, making sure all complications are minimized and that every document is prepared correctly. Concierge Specialist ensures that every step of the process is being watched and that you can go about your day with confidence that your passport and/or visa request is in the best possible hands. Once a request is made, Visa And More's Concierge Service begins by assigning a dedicated Specialist who will reach out to you to discuss your needs and make the process as simple, quick and hassle free.

Additional Concierge Service Highlights:

Assistance with document preparation and review to minimize any rejections or delays;
Application forms completed and delivered for signature;
Secondary personal review of all documents prior to submission;
Review and recommendation of most appropriate visa and service level based on needs;
Personalized updates during all phases of the process via preferred method of contact;
Visa And More Concierge Service — Additional fee per traveler: $195 in addition to US State Department/foreign consular fees. $75 per additional destination/service.

For questions : Call 832-413-3669 OR Email : services@thevisaandmore.com

Email address *
1. Personal Information
Last Name
Your answer
Given Name
Your answer
Last Name at birth
Your answer
Former Last Name
Your answer
Place of birth (City, State and Country)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Sex
Natural Eye Color
Your answer
Height (cm/in)
Your answer
Current Home Address
Your answer
Mailing Address (if different from current home address)
Your answer
Telephone (daytime)
Your answer
Telephone (Other)
Your answer
Email address
Your answer
2. Declaration of Guarantor
The guarantor needs to sign this portion and should be known to you for at least 2 years.
Given Name
Your answer
Date of birth
MM
/
DD
/
YYYY
Canadian passport number
Your answer
Date of issue
MM
/
DD
/
YYYY
Date of expiry
Relationship to the applicant
Your answer
Telephone (daytime)
Your answer
Telephone (other)
Your answer
Current home address
Your answer
3. Previous Canadian Travel Document
Has a Canadian travel document (passport, certificate of identity or refugee travel document) been issued to you?
If Yes, provide Number, Date of Issue
Your answer
4. Proof of Canadian Citizenship
A) To be completed if you were born in Canada. Provide one (1) of the documents listed below (original only):
Provide Registration/Certificate Number and Date of Issue or Effective date of citizenship
Your answer
B) To be completed if you were born outside of Canada.1) Provide one (1) of the documents listed below (original only):
Provide Certificate number and Date of issue or Effective date of citizenship
Your answer
2) To be completed if you were born outside of Canada between February 15, 1977 and April 16, 1981 inclusive(you do not need to complete this section if you are presenting a certificate of Canadian citizenship issued after January 1, 2007).
Your answer
a) Are you a naturalized Canadian, i.e. did you receive Canadian citizenship following immigration to Canada?
b) Was one of your parents born in Canada?
5. Documents to Support Identity (Copy of Driving License and/or Passport issued by other country)
Provide Number, Date of expiry and Your name as it appears on the document
Your answer
6. Period of New Passport's Validity
Choose one (1) of the following periods of validity
7. Additional Personal Information
A) Addresses in the last two (2) years : Choose one (1) of the following periods of validity
B) Occupation in the last two (2) years (check all that apply)
Provide full details below for the last two (2) years occupation (Employer/school or other, Address, Telephone, Field of employment or studies, Period (Date from and Date to)
Your answer
C) Mother's maiden name
Your answer
8. References
First Reference: Complete Name, Relationship, Address, Phone Number, Email Address and For how many years known to you
Your answer
Second Reference: Complete Name, Relationship, Address, Phone Number, Email Address and For how many years known to you
Your answer
9. Emergency Contact Information
Provide Complete Name, Relationship, Telephone Number, Email address, current home address
Your answer
I confirm that the particulars given above are true and correct to the best of my knowledge and belief. *
Your answer
Upload Documents
Please send the following documents to services@thevisaandmore.com separately:
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