Statutory Declaration of Common-Law Union (IMM 5409)
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Statutory Declaration of Common-Law Union [IMM 5409] (PDF, 1.4 MB)
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Statutory Declaration of Common-Law Union (IMM 5409)
Who must complete this form?
This form must be completed and signed with handwritten signatures.
Submitting an application to sponsor a family member
- If the sponsor's common-law partner is a co-signer on the application to sponsor
- the sponsor and their common-law partner must complete this form.
- If the person being sponsored (the principal applicant) has a common-law partner
- the person being sponsored and their common-law partner must complete this form.
- Question 1
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Write the following information in the space provided:
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- Country of current residence
- Province/state/territory of current residence
- Name of the declarant (as shown on passport/travel document)
- Name of the declarant’s partner (as shown on passport/travel document)
- Name of city, town, village
- Name of county (if applicable)
- Name of province/state/territory
- Name of the country
- Number of continuous year(s) in a conjugal relationship
- Date of the relationship (from-to)
- Question 1A
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Check the box to indicate if you have jointly signed a residential lease, mortgage or purchase agreement relating to a residence in which you both live.
- Question 1B
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Check the box to indicate if you jointly own property other than your residence.
- Question 1C
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Check the box to indicate if you have a joint bank, trust credit union or charge card accounts.
- Question 1D
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Check the box to indicate if you have declared your common-law union under the Canadian Income Tax Act (T-1 “General individual income Tax Return”).
- Question 2
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Check the box to indicate if you have life insurance on yourself which names your common-law partner as a beneficiary.
- Question 3
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Check the box to indicate if your common-law partner has life insurance on themselves which names you as a beneficiary.
- Question 4
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If you answered “no” to questions 1 to 3, indicate other documentary evidence you have that would indicate your relationship as common-law partners.
- Question 5
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solemn declaration
Write the following information in the space provided: -
- Name of the declarant (as shown on passport/travel document)
- Name of the declarant’s partner (as shown on passport/travel document)
- Name of the city, town, village
- Name of the county
- Name of the province/state/territory
- Name of the country
- Date (day, month, year)
- Signature of the declarant
- Signature of the declarant’s partner
- Name of the person who administered the declaration
- Select the person’s title from the choices provided
- Signature of the person who administered the declaration
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