材料1-孩子领取加拿大护照-父母一方失联公证书-样本

圆◆魔GovernmentGouvernementof Canadadu CanadaSaveReset FormPrint FormPROTECTED WHEN COMPLETED-BPage 1 of 4STATUTORY DECLARATION-OTHER PARENT OR LEGAL GUARDIAN:Whereabouts Unknown or Refusal to Sign the Child's Travel Document ApplicationWARNING-Any false or misleading statement on this form or relating to any document in support of this application,including concealmentof any material fact,may lead to refusal or revocation of a Canadian travel document.IMPORTANT-This statutory declaration should only be used when:☑the current whereabouts of the other parent or legal guardian is unknown;the acknowledgment from the other parent or legal guardian is required but they refuse to sign the application form.This statutory declaration cannot be used when the parents or legal guardians share custody or decision-making responsibility.INSTRUCTIONSThe applicant parent or legal guardian must complete and sign a separate form for each child's passport application under oath or by solemn declaration in thepresence of a person who,by law,is authorized to administer an oath or a solemn declaration.If the declaration is completed outside Canada,a qualifiedofficial includes a Canadian diplomatic or consular representative or a local official.When no documentation pertaining to the child that refers to custody,decision-making responsibilities,access,parenting time and/or mobility exists:Please complete all sections.In all other situations:Please complete Sections A,B,C,E and F.Failure to complete all the required sections of this form will result in your application being rejected.Type or print in CAPITAL LETTERS using black or dark blue ink.SECTION A|CHILD'S PERSONAL INFORMATIONChild's surname(last name)Child's given name(s)Child's date of birth(YYYY-MM-DD)Child's Place of birthCityProvince/Territory/State (if applicable)CountrySECTION BI APPLICANT PARENT'S OR LEGAL GUARDIAN'S PERSONAL INFORMATIONSurname (last name)Given name(s)SECTION CI INFORMATION ON THE OTHER PARENT OR LEGAL GUARDIAN AND LEGAL DOCUMENTATION.If insufficient space to provide all of the required information,attach a separate signed and dated sheet of paper.1.Other parent's or legal guardian's informationPlease provide the last known contact information of the other parent or legal guardianNote:Your contact information will not be disclosed to this other parent.Surname(last name)Given name(s)Telephone (davtime)Telephone (cell)Email addressPPTC(DISPONIBLE EN FRANCAIS-PPTC 279 F)Canada