Permanent Resident Card Renewal Assessment Form All information submitted is kept strictly confidential. View Privacy Policy A. PERSONAL DETAILSFull Name*Email Address*Phone Number*Gender*MaleFemaleFull Postal Address*City*State/Province*Zip/Postal Code*Place of Birth*Date of Birth*(If the calendar icon does not work, please manually enter the date using YYYY-MM-DD format.)Citizenship*Marital Status*Please selectSingle / Never MarriedMarriedDivorced / WidowedCommon LawConjugal RelationshipAre you a permanent resident of Canada?*YesNoWhen did you obtain permanent residence?*(If the calendar icon does not work, please manually enter the date using YYYY-MM-DD format)Do you have an existing PR Card?*YesNoWhen does/did the card expire?*(If the calendar icon does not work, please manually enter the date using YYYY-MM-DD format)Are you currently living in Canada?*YesNoWhere do you currently reside?*When is the last time you were in Canada?*Have you physically resided in Canada for at least 2 years in the past 5 years?*YesNoHow many days have you been in Canada in the last 5 years?*How often have you travelled out of Canada in the past five years?*Please selectDid not travelOccasionalFrequentWhat countries have you travelled to in the past 5 years?*Have you been working outside of Canada for a Canadian company?*YesNoPlease provide details of the periods that you have been working outside of Canada for a Canadian company*Have you been living with a Canadian citizen spouse or partner outside of Canada?*YesNoWhat periods of time have you been living with your Canadian spouse or partner outside Canada?*If you have not been able to meet the residence requirement, please explain any Humanitarian and Compassionate grounds that exist in your case explaining why you have not been able to live in Canada.*B. APPLICANT ADMISSIBILITYAre you currently under a removal order?*YesNoAre you currently appealing a negative residency determination?*YesNoHas your Canadian permanent residence been revoked?*YesNoIf you have replied “yes” to any of the above questions, please provide details:C. FINAL DETAILSIf there is anything else that you believe is important in relation to your case please note it here:DECLARATIONI certify that the above information provided by me in the Free Assessment is true and I agree to Matthew Jeffery's Privacy Policy & Use of Terms.*Yes, TrueFurthermore, I consent to the law office of Matthew Jeffery, Barrister & Solicitor, contacting me in relation to the above Free Assessment.*YesSendThis field should be left blank