PROTECTED WHEN COMPLETED - B

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SUPPLEMENTARY INFORMATION
YOUR TRAVELS
The principal applicant must complete this form.
If you need more space for any section, please add lines to the form by pressing the + button. If you apply on paper, print out an additional page
containing the appropriate section, complete it and submit it along with your application. Print your name and the form's title on the additional sheet.

1 - Your full name FOR OFFICE USE ONLY

Family name (as shown on passport/travel document)

Given name(s) (as shown on passport/travel document)

2 - List all trips you and your family members aged 18 or over (if applicable) have taken outside your country of origin or of residence in the last ten years (or
since your 18th birthday if this was less than ten years ago). Include all trips: tourism, business, training, etc. If you or your family member did not travel
outside of your country of origin or of residence during this period, check "did not travel".
For example:

From To Destination Provide details

Duration Purpose of travel
YYYY - MM YYYY - MM (City and country) (if applicable)

2020-04 2020-04 6 days Madrid, Spain Tourism Guided tour, Sightseeing

a) You did not travel

From To Destination Provide details

Duration Purpose of travel
YYYY - MM YYYY - MM (City and country) (if applicable)

b) Your spouse or common-law partner (if not a Canadian citizen or permanent resident of Canada).
Family name and given names (as shown on passport/travel document) did not travel

From To Destination Provide details

Duration Purpose of travel
YYYY - MM YYYY - MM (City and country) (if applicable)

(DISPONIBLE EN FRANÇAIS - IMM 5562 F)

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) Your dependent child 18 years old or older

Family name and given names (as shown on passport/travel document)
did not travel

From To Destination Provide details

Duration Purpose of travel
YYYY - MM YYYY - MM (City and country) (if applicable)

+ -
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3 - Signature
I certify that the information contained on this document is complete, accurate and factual. I also realize that once this document has been completed and signed that it will form part of
my Immigration Record and will be used to verify my family details on future applications.
Signature: Date (YYYY-MM-DD)

Personal information provided on this form is collected by Immigration, Refugees, and Citizenship Canada (IRCC) under the authority of the Immigration and
Refugee Protection Act (IRPA). The personal information will be used for the purpose of processing an application. The personal information provided may be
disclosed to other federal government institutions, law enforcement bodies, non-governmental organizations, provincial/territorial governments and foreign
governments for the purpose of validating identity, admissibility and eligibility.

Personal information may also be used for other purposes including research, statistics, program and policy evaluation, internal audit, risk management,
subsequent program eligibility, strategy development and reporting.

Failure to complete the form in full may result in a delay or the application not being processed. The Privacy Act gives individuals the right of access to,
protection, and correction of their personal information. If you are not satisfied with the manner in which IRCC handles your personal information, you may
exercise your right to file a complaint to the Office of the Privacy Commissioner of Canada. The collection, use, disclosure and retention of your personal
information is further described in IRCC’s Personal Information Bank – IRCC PPU 042.