IRCC Form IMM 5669: Fillable PDF
Schedule A: Background / Declaration
Immigration, Refugees and Citizenship Canada
Provide personal history, education and background declaration for a permanent residence application.
Reviewed July 2026
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How it works
- 1
Download the form. Save the official PDF to your device.
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Open it in Adobe Acrobat Reader and fill in each field. Browsers show a placeholder page for this form type.
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Save and submit the completed form following the official instructions.
Form IMM 5669, Schedule A: Background / Declaration, is the background disclosure form used in Canadian permanent residence applications. It collects education history, a continuous personal history of work, study, and other activities, addresses, organizational memberships, government positions, and military service, and it includes declaration questions about criminality, detention, and prior refusals that support security and admissibility screening.
IMM 5669 is a dynamic XFA form and only opens in Adobe Acrobat Reader on a computer. Download the official PDF from this page, save it, and open the saved copy in Acrobat Reader; browsers display a placeholder page instead of the form. Because IRCC pins applications to form versions, confirm the current one on canada.ca before you file.
What is Form IMM 5669 used for
Schedule A feeds directly into the background checks that every permanent residence applicant undergoes. Security partners use the addresses, activities, and memberships you list to run their screening, which is why the form insists on complete coverage of the required period with no unexplained gaps.
The declaration questions ask about matters such as criminal charges and convictions, refused visas, deportations, involvement with organizations that have used violence, and military or security service. Answering these truthfully matters more than anywhere else in the application; a false answer is misrepresentation and can lead to refusal and a multi-year ban.
Who completes IMM 5669
IRCC generally requires a Schedule A from the principal applicant and from family members aged 18 or over, whether they are accompanying or not, depending on the program. Your document checklist or a request letter tells you exactly who must submit one and for what period.
- Applicants in family class, economic, refugee, and humanitarian permanent residence streams, when requested.
- Spouses, partners, and dependent children aged 18 or over, where the checklist requires it.
- Applicants asked to resubmit during processing; IRCC often requests a fresh Schedule A with updated dates.
How to fill out IMM 5669
Open your saved copy in Adobe Acrobat Reader and work chronologically. The personal history section typically covers the period the instructions specify, often the last ten years or since age 18, and it must be continuous: every month accounted for, including unemployment, homemaking, or travel.
- Answer every declaration question; if one applies, explain the circumstances in the space provided or on an attached sheet.
- List education from secondary school onward with institutions, dates, and credentials.
- Account for all periods in the personal history with no gaps, using entries like unemployed or student where relevant.
- Keep addresses, employers, and dates consistent with IMM 5562, IMM 0104, and your other forms.
- Validate the form in Acrobat Reader, print it, and sign where required.
Avoiding gaps and inconsistencies
Unexplained gaps are the single most common reason officers send Schedule A back or issue procedural fairness letters. Before submitting, line the form up month by month against your resume, travel history, and address history.
If you have anything sensitive to declare, such as an old conviction, a prior refusal, or military service, disclose it and explain it. A regulated Canadian immigration consultant or an immigration lawyer can help you present difficult history accurately without volunteering errors.
Frequently asked questions
IMM 5669 is a dynamic XFA PDF, and browsers cannot render that format, so they show a placeholder page. Download the file and open the saved copy in Adobe Acrobat Reader on a computer to complete it.
Typically the period stated in your checklist or request letter, often the last ten years or since your 18th birthday, whichever is more recent. The history must be continuous with no gaps.
Any stretch of time with no entry. Periods of unemployment, caregiving, travel, or recovery from illness are all fine to include; what causes problems is leaving the time unaccounted for.
Yes. The declaration questions have no time limit or seriousness threshold, and nondisclosure discovered later is treated as misrepresentation. Declare it and explain; many old or minor matters have little effect when disclosed honestly.
Usually yes; IRCC generally wants a Schedule A from each family member aged 18 or over included in the application, accompanying or not. Confirm on your document checklist.
Background checks are time limited, so if processing takes long, IRCC often requests an updated IMM 5669 covering the time since your last one. Complete the new version promptly and consistently with the original.
Related forms
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