Schedule A: Background / Declaration Form (IMM 5669)

Jurisdiction: Country: Canada | Province or State: Federal

What is a Schedule A: Background / Declaration Form (IMM 5669)?

Schedule A is a federal background and declaration form for immigration. It records your identity, personal history, addresses, education, work, and affiliations. It also asks about military service, government roles, and any criminal or security concerns. You sign it to confirm everything is true and complete.

You use this form to help the government assess your admissibility. The form helps confirm who you are, where you have been, and what you have done. It lets officers check for security risks, criminality, or misrepresentation. It also helps them verify your education and work history.

Who typically uses this form?

Almost all adult applicants for permanent residence need it. Many spouses or partners being sponsored also need it. Dependent children who are 18 or older usually need their own form. Some temporary resident applicants are asked for it when there are background concerns. Some refugee claimants, protected persons, and humanitarian applicants use it as well. If you apply through an economic, family, or protection pathway, expect to complete it.

Why would you need this form?

The government must ensure only admissible people enter or remain in Canada. The form gives them the data to run checks and to match your evidence with your story. If you have lived in several countries, changed names, or held sensitive roles, this form is essential to explain your history. If you have any criminal charges or convictions, you disclose them here with context. If you have nothing to declare, the form still documents that fact.

Typical usage scenarios

You submit Schedule A with your permanent residence application under an economic class. You submit it later on request because an officer needs updated details. You submit it when you sponsor your spouse, and both you and your spouse complete separate forms. You submit it as a protected person to document your background. You submit it for a temporary application if asked due to complex travel or work history. You submit it again if your first version is outdated or had gaps.

Treat this form as a sworn background statement. It is not just administrative. Officers use it to assess your credibility. They compare it with your other forms, your passport stamps, and any police checks. If facts do not line up, they may refuse your case or ask for more proof. If your form is detailed, consistent, and clear, your file moves faster.

When Would You Use a Schedule A: Background / Declaration Form (IMM 5669)?

You use Schedule A when the application instructions list it in your checklist. That happens for most permanent residence applications. It also happens in many sponsorship files. The form may be required at the start or later. Sometimes the portal collects the fields online instead of a standalone upload. The questions are the same. In both cases, you need the same depth and accuracy.

You also use the form when an officer asks for it as an update. This is common if your case takes time and your personal history changed. For example, you moved, changed jobs, or completed a degree. You may also need to refresh it if the original had gaps. Officers often ask for a corrected version when months do not match or addresses skip time. If your Schedule A is stale or inconsistent, submit a new version as soon as requested.

Typical users include principal applicants seeking permanent residence under an economic route. Spouses or partners being sponsored complete it as well. So do dependent children who are 18 or older. Students who become workers and then apply for permanent residence also complete it. Refugee claimants or protected persons complete it to confirm their identity and history. Entrepreneurs and self‑employed applicants complete it to disclose roles and affiliations.

You may also use Schedule A for other reasons. If you need a temporary resident permit due to inadmissibility, the officer may request it. If you ask for humanitarian relief, the officer will want full background information. If you had a previous refusal, the form helps you explain past issues. In some cases, people with limited documents provide extra detail in Schedule A to support identity and residence claims.

In short, use Schedule A whenever the instructions ask for it. Use it again if your facts change before a decision. Use it to fix gaps or errors. Use it to explain any “Yes” answers about charges, detention, or security issues.

Legal Characteristics of the Schedule A: Background / Declaration Form (IMM 5669)?

Schedule A is a legal declaration. You sign it to certify the truth and completeness of your answers. This makes it binding on you. If anything is false or omitted, you risk refusal and enforcement. Misrepresentation can also lead to a period of inadmissibility. That can bar you from future applications for a number of years. It can also lead to removal in serious cases.

What ensures enforceability?

The form includes clear warnings. You certify that you understood the questions. You declare that your answers are complete. You authorize checks to verify the information. Officers can compare your answers with government records and other countries’ records when allowed by law. They can also check your travel history, past applications, and security databases. If they find contradictions, they can act.

The form’s structure also supports enforceability. It asks for full addresses. It asks for personal history with no gaps since your 18th birthday or for the last 10 years, whichever is longer or as specified. It asks about arrests, charges, and convictions in any country. It asks about membership in organizations, including political, professional, and social groups. It asks about military and government roles. Each section requires dates down to the month. The design reduces ambiguity and makes cross‑checks easier.

General legal considerations matter. Answer all questions. If a question does not apply, write “Not applicable.” Do not leave blanks. Use exact month and year for start and end dates. Do not estimate if records exist. If you lack records, explain that in an attached note. Use a separate sheet for long histories. Keep consistent spellings for names and places. List all previous names, including different spellings, transliterations, or name changes at marriage or divorce.

Disclose charges even if they were later withdrawn or dismissed. Disclose convictions even if you completed a sentence or paid a fine. If your record was sealed or suspended, state that and give details you still know. If your answer is “Yes” to any criminal or security question, attach a short, factual explanation. Focus on dates, locations, legal outcomes, and current status. Avoid excuses or opinions.

Provide translations for any documents or explanations that are not in English or French. Include the translator’s certification. For online forms, prepare translations as PDFs and label them clearly. If you submit a paper form, place the translations behind your explanations.

Each adult applicant must sign their own form. For a minor child, a parent or legal guardian signs if the form is requested. If your form is paper, sign in ink. Write the date in the required format. Do not sign for someone else. For online submission, follow the portal’s signature instructions. A typed name can be a legal electronic signature when the system requires it. Do not submit an unsigned form.

Finally, keep your Schedule A current. If your situation changes before a decision, update the form. That includes moves, job changes, new studies, marriage or divorce, and new charges. An officer may reach a negative decision if your form no longer reflects your real status. Updating shows good faith and prevents misrepresentation by omission.

How to Fill Out a Schedule A: Background / Declaration Form (IMM 5669)

Start by gathering information

• You need your passport, travel documents, education records, and employment records.
• You also need addresses for at least the last 10 years or since your 18th birthday.
• You need exact month and year for each change in address, job, or status.
• Set aside an hour to complete the form without rushing.

Begin with your personal details

• Enter your full legal name exactly as in your passport.
• Include all given names and your family name.
• List any other names you use or used.
• Include maiden names, nicknames used on official records, and different spellings.
• Provide your date and place of birth.
• Provide your current marital status.
• If you had prior marriages or partnerships, list each with dates and status changes.
• Keep places and dates precise.

Add your identity document details

• Provide your passport number, country of issue, and expiry date if asked.
• If you have a client identifier from a past application, include it if the form requests it.
• If you do not have one or do not know it, write “Not applicable.” Ensure dates match your passport and other application forms.

Complete the education section

• Start with your highest level achieved.
• Provide the name of the institution, field of study, and city and country.
• Provide start and end month and year.
• Include secondary school if the form asks for it.
• Do not skip vocational programs, apprenticeships, or training courses.
• If you are still studying, write “Present” as the end date and explain the current status.

Fill in your personal history

• This section is critical. List what you have been doing since your 18th birthday or for the last 10 years, as the form requires.
• Use month and year for each activity.
• Do not leave any gaps.
• If you were unemployed, write “Unemployed” and give the city and country.
• If you were studying, write “Student.”
• If you were on parental leave, say so.
• If you were traveling, note “Travel,” the countries visited, and your base location.
• If you did two things at once, such as part‑time study and work, enter both lines with overlapping dates.
• Make sure your employment and study entries match your resumes and letters.

Complete your address history

• List every place you lived for the last 10 years or since age 18.
• Use month and year for moves. Include the full street address if available.
• Include the city, state or province, country, and postal code.
• If you lived on campus housing, list the residence address.
• If you couch‑surfed or stayed with friends, provide the street and city to the best of your ability.
• Do not leave any month without an address.
• If you were abroad for long visits, show the foreign address during that time.

Disclose organization memberships and affiliations

• The form asks about political, social, professional, and student organizations.
• Include unions, alumni groups, professional associations, and any group where you held a role.
• Provide the name, location, role, and dates.
• Do not omit groups because they seem minor.
• Officers use this to assess risk and context.
• If you were simply a paying member without activity, state that.

Provide military, police, security, or government service details

• If you served in the military, list units, ranks, duties, and locations.
• Include conscription and reserve service.
• If you worked for police or security services, provide divisions and functions.
• If you held any government positions, list titles, departments, and dates.
• Be clear about the nature of your work.
• Explain if your role was administrative or technical.
• Avoid jargon.
• Use plain job titles in English or French.

Answer the criminal and security questions

• These are the “Yes” or “No” declarations. Read each question slowly.
• Answer honestly. A “Yes” answer does not always mean refusal. It signals that you must explain. If you answer “Yes,” prepare a short attachment. Include the date, place, event, and outcome. For example, “June 2018, City X, charged with offence Y, case dismissed in October 2018.” Attach court records if you have them.
• Keep explanations factual and brief.

Review consistency across your application

• Names, dates, jobs, and addresses must match other forms.
• Check work permits and visas for dates.
• Check passport stamps against travel dates that affect your residence timeline.
• If something seems inconsistent, add a note to explain. For example, “Lived in Country A, month 1 to month 12, with frequent business trips to Country B.”

Prepare continuation sheets if you need more space.

• At the top of each sheet, write your full name, date of birth, the form title, and the section you are continuing.
• Keep the same format as the form: month/year, activity, city, country.
• Number each page.
• Sign and date each continuation sheet.
• Upload them as separate PDFs if you are filing online, or attach them behind the form for paper filing.

Identify the parties to the form

• The parties are you, your spouse or partner if they are an applicant, and each dependent child aged 18 or older.
• Each adult completes and signs their own Schedule A.
• The principal applicant does not sign for other adults.
• If a minor must submit a form, a parent or legal guardian completes and signs on their behalf.

Understand the clauses you are agreeing to

• The form contains declarations that your information is true and complete.
• It includes consent that allows information checks.
• It includes warnings about penalties for false statements.
• When you sign, you accept those clauses.
• Read them before you sign.
• If any clause is unclear, do not guess.
• Seek clarification before submission.

Sign and date the form correctly

• For paper forms, sign with a handwritten signature.
• Use dark ink.
• Date the form on the day you sign.
• Do not post‑date.
• For online forms, follow the portal’s signature steps.
• Usually, you type your name and answer a security prompt.
• That acts as your legal electronic signature.
• Verify the date displayed after you sign.

Attach supporting schedules where needed

• If you answered “Yes” to any security or criminal questions, attach a short schedule of explanations.
• If your personal history or addresses exceed the space, attach a continuation schedule.
• If your names have complex transliterations, attach a name table showing variations.
• Label each schedule with your name, date of birth, and the section number.
• Keep each schedule concise and factual.

Do a final quality check

• Confirm there are no gaps in time.
• Confirm all place names are consistent.
• Confirm that you used the required language.
• Confirm that every adult applicant has a signed form.
• Confirm that translations are included.
• Save a complete copy of what you submit.
• You may need it if the officer asks about a detail months later.

After submission, monitor for changes in your situation

• If you move, change jobs, change marital status, or face new charges, update your Schedule A.
• Use the same channel you used to submit your application.
• Include a brief cover note that lists the changes and the effective dates.
• Send the updated form and any new explanations.
• Acting quickly helps protect your file from negative findings.

Avoid common mistakes

• Do not round dates to the nearest year.
• Do not abbreviate organization names without writing the full name at least once.
• Do not write “same as above” for addresses.
• Each line needs full details.
• Do not leave a month blank because you were between jobs.
• Use “Unemployed” for those months and include your city and country.
• Do not rely on memory if records exist. C
• heck old emails, leases, and pay slips to confirm dates.
• If you are unsure about a detail, explain.
• A short note such as “Unsure of exact day; month and year are correct” can prevent confusion.
• If you changed your name, attach proof of the change.
• If your passport lists different spellings across pages, mention that.
• Clarity reduces follow‑up requests and speeds up the process.

Your goal is a complete, consistent, and truthful picture of your background. That is what officers need to finish their assessment. Take the time to get this form right. It can make the difference between a smooth review and a long delay.

Legal Terms You Might Encounter

• Schedule A – Background/Declaration: This is the background form you complete for many immigration applications. It asks about your identity, history, and declarations. You use it to show where you lived, studied, and worked. You also answer security and admissibility questions.
• Principal applicant: This is the person leading the application. If you apply with your family, the principal applicant is the one whose qualifications the application rests on. The principal applicant completes a Schedule A. Certain family members may need one as well, depending on the program.
• Dependent family member: This usually means your spouse or partner and dependent children. Some dependents may need to complete their own Schedule A. If they do, they must disclose their own history and declarations, not the principal applicant’s.
• Unique Client Identifier (UCI): This is your client number with the immigration system, if you have one. It helps link your past and current files. If you have a UCI from a past application, include it on Schedule A wherever asked. If you do not have one, follow the form’s instructions for that field.
• Personal history: This is your timeline of what you did over a given period. It covers work, studies, unemployment, homemaking, travel, and other activities. On Schedule A, you must list this history with no gaps. Every month must be accounted for.
• Address history: This is the list of places you lived during the stated period. You include street addresses, cities, and countries. You provide the dates you lived at each address. Schedule A requires a complete address history with no gaps.
• Statutory questions: These are yes/no questions about sensitive topics. They cover issues like crimes, arrests, refusals of visas, removals, military service, and organizations. You must answer each one truthfully. If you answer yes, you will need to explain the details.
• Inadmissibility: This means you may not be allowed to enter or remain in the country under the law. Reasons can include security, criminality, medical, or misrepresentation. Schedule A helps the department assess admissibility. Your answers affect that assessment.
• Misrepresentation: This means giving false, incomplete, or misleading information. It can be intentional or careless. Misrepresentation can lead to refusal and penalties. On Schedule A, leaving out past refusals, addresses, jobs, or names can count as misrepresentation.
• Background check and security screening: These are reviews the department carries out using your Schedule A and other data. They verify your identity, personal history, and declarations. Clear and consistent answers help the review move faster. Inconsistent or missing details can slow it down.
• Removal order: This is an official order to leave the country. If you have ever received one, you must disclose it on Schedule A. You also explain the context and the date. Non-disclosure can lead to refusal for misrepresentation.
• Refusal: This is when a past application, visa, or permit request was denied. Schedule A asks if you have ever been refused status or a visa. You must report each refusal, with dates and reasons if you have them. Refusals do not automatically sink your case, but hiding them can.

FAQs

Do you need to list unpaid work, internships, or volunteer roles?

Yes. Include unpaid work, internships, and volunteer roles in your personal history. Mark them clearly as unpaid or volunteer. The goal is to show a complete month-by-month timeline. Do not leave a gap just because the role was unpaid.

Do you include periods when you were not working or studying?

Yes. List unemployment, homemaking, parental leave, medical leave, travel, or job searching. Use plain terms like “Unemployed – seeking work” or “Homemaker.” Include start and end dates for each period. Every month must be covered.

Do you need to report military service or government positions?

Yes. Schedule A asks about military and government roles. List each role with dates, unit or department, location, and duties. If asked about conscription, explain whether service was mandatory. If you held any rank or security clearance, include that.

What if you cannot recall exact dates?

Use the format the form allows. If you cannot recall a day, give month and year. Check old emails, tax slips, transcripts, contracts, passports, housing leases, or bank statements to verify dates. If you still cannot confirm, give your best good‑faith estimate. Keep a short note explaining how you estimated.

Do you need to report past refusals or removals?

Yes. Disclose all past refusals, withdrawals after concerns were raised, and removal orders. Include the country, decision date, and brief reason if known. Refusals do not end an application. Non-disclosure can cause refusal for misrepresentation.

Should you list short stays or vacations in your personal history?

List them only if they affected your personal history or address history. For example, a three‑month stay abroad may change your address. A one‑week vacation likely does not. Always follow the instructions on the form. When unsure, include more detail rather than less.

Can you handwrite the form?

Follow the method the form allows. If you must handwrite, print clearly in block letters using dark ink. Keep all entries legible and consistent. If typing is allowed, type your answers to avoid readability issues. In all cases, sign and date where required.

Who must complete and sign Schedule A?

Each person required by the application must complete their own Schedule A. That often includes the principal applicant and some dependents. Adults sign for themselves. A parent or legal guardian signs for minors, unless the form says otherwise. If an interpreter helped you, complete the interpreter section if the form includes one.

What if the department asks for a new Schedule A later?

Sometimes the department requests an updated Schedule A. This can happen if processing takes time or your situation changes. Complete the new form with your most current information. Make sure all dates and entries match your recent history.

Is there a fee for Schedule A?

This form itself usually has no separate fee. It is part of your application package, which may have fees. Pay all required application fees as directed in your program’s instructions.

Checklist: Before, During, and After the Schedule A

Before you sign

• Identity details
• Passport or travel document.
• Full legal names, including all other names used.
• Date and place of birth.
• UCI, if you have one.
• Name history
• All previous names, spellings, and name changes.
• Marriage, divorce, or legal change documents if relevant.
• Personal history records
• Employment records, contracts, or letters.
• Education transcripts and diplomas.
• Unemployment periods, parental leave dates, or medical leave letters.
• Volunteer or internship confirmations.
• Address history records
• Leases, utility bills, bank statements, or letters showing past addresses.
• Dates you moved in and out.
• Government or military records
• Service books, discharge papers, unit details, rank, and duties.
• Government position letters or contracts.
• Past immigration interactions
• Reference numbers for past applications, approvals, refusals, or removals.
• Decision dates and reasons if known.
• Police or court information
• If you ever had charges, convictions, or cautions, gather dates and documents.
• Prepare a short factual summary for any yes answers.
• Language and interpreter
• If you need an interpreter, arrange a qualified person.
• Ensure interpreter details are available if required on the form.
• Technology and file storage
• If completing electronically, ensure you can save and print clearly.
• Set up a secure folder to store drafts and final copies.

During completion and signing

• Verify identity entries
• Your full name matches your passport.
• All other names and spellings are listed.
• UCI entered correctly, or the field marked as not applicable.
• Check personal history
• The timeline covers every month in the required period.
• No gaps between entries, even for unemployment.
• Job titles, employer names, and locations are accurate.
• Education entries include program names and institutions.
• Volunteer and internship roles are labelled.
• Check address history
• Each address has a start and end date.
• No overlapping or missing months unless explained.
• City, region, and country fields are filled out.
• Review statutory questions
• Every yes/no question is answered.
• Yes answers have complete explanations with dates and details.
• Explanations are factual and concise.
• Military and government roles
• Units or departments listed.
• Duties and locations summarized.
• Mandatory service identified as such, if applicable.
• Consistency checks
• Names, dates, and locations match across your forms.
• Employment dates align with reference letters and resumes.
• Address dates align with leases and utility records.
• Signatures and dates
• Sign in all required boxes.
• Use the correct date format.
• If an interpreter helped, complete their section.
• Legibility and formatting
• Print clearly if handwritten.
• Use the form’s date format.
• Avoid abbreviations that could confuse a reviewer.

After signing

• Save copies
• Keep a digital copy (PDF or image) and a printed copy.
• Back up your files in secure storage.
• Assemble your package
• Place Schedule A with the correct application or upload it as instructed.
• Label any attachments with your name and date of birth.
• File the form
• Submit it through the channel required for your application.
• Confirm submission and keep any confirmation numbers.
• Notify changes
• If your situation changes, prepare an updated Schedule A.
• Use the official method to send updates to the department.
• Track your file
• Keep your application number and UCI handy.
• Check for messages that may request a new Schedule A or clarifications.
• Keep your documents aligned
• Ensure future submissions (police checks, letters) match your Schedule A.
• Correct any inconsistency as soon as you spot it.

Common Mistakes to Avoid

Leaving gaps in your personal or address history

• Don’t forget to cover every month.
• Gaps invite questions and delays.
• If you were unemployed or traveling, say so with dates.

Hiding past refusals or removals

• Do not omit refusals or removals.
• The department can see past records.
• Non-disclosure can lead to refusal for misrepresentation.

Guessing dates without checking records

• Avoid rough guesses.
• Check emails, contracts, and transcripts.
• If you must estimate, use the allowed format and be consistent.

Inconsistent names and spellings

• List all other names you have used.
• If your documents show different spellings, note them.
• Inconsistencies slow identity checks.

Missing signatures or dates

• Do not leave signature sections blank.
• Missing signatures make the form invalid and can stall your file.

Overly long or unclear explanations

• Keep yes-answer explanations factual and concise.
• Stick to dates, places, and outcomes.
• Avoid opinions or unnecessary detail.

Using abbreviations or nicknames

• Use full legal names for people, employers, schools, and places.
• Abbreviations can create confusion and mismatches.

What to Do After Filling Out the Form

1. File it with your application
2. Submit Schedule A with the rest of your application as required. If you were asked to provide it later, follow the instructions in that request. Keep proof of submission.
3. Store a clean copy
4. Save a final, signed copy in a secure folder. Use a clear file name with your name and date. Keep a printed copy in a safe place. You will need it to answer future questions.
5. Align your supporting documents
6. Make sure your letters, transcripts, and police or court records match your Schedule A. If an entry is hard to verify, prepare a short, factual note explaining why.
7. Prepare for follow-up requests
8. The department may ask for an updated Schedule A. They may also request clarifications. Respond by the deadline. Use the same structure and dates you used before, updated as needed.
9. Update the department if something changes
10. If you change your address, job, relationship status, or travel for a long period, consider whether that affects your Schedule A details. If it does, send an update using the official channel for your application.
11. Correct mistakes as soon as you spot them
12. If you find an error after submission, prepare a corrected Schedule A or a clear explanation page. Send it through the approved method, referencing your file number. Explain what changed and why.
13. Stay consistent across all forms
14. Your Schedule A should agree with your other forms. Cross-check names, dates, job titles, and addresses. If a date differs across forms, reconcile it and update the record.
15. Track timelines
16. Some background checks take time. Accurate, consistent entries help reduce follow-up questions. Watch your messages for any requests. Answer promptly and clearly.
17. Plan future disclosures
18. If you will need police certificates or other checks, ensure your Schedule A entries match those documents. If a record is sealed or hard to obtain, note what you can and explain the steps you are taking.
19. Keep your contact details current
20. If your email or phone changes, update your contact information using the official channel. You risk missing a request if your contact details are outdated.