Statutory Declaration for Extended Family Members Outside Canada of a Canadian Victim of an Air Disaster that may apply for a Permanent Residence Visa

Source-derived guide with citations. Always confirm the exact forms required for your program and use the latest versions from IRCC.

IMM 0171 is an official IRCC form. IMM 0171 is a form for extended family members outside Canada of a Canadian victim of an air disaster who may apply for a Permanent Residence Visa. Use the current version of this form and follow the checklist relevant to your situation.

Last reviewed: 2026-01-30

Overview

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IMM 0171 is a form for extended family members outside Canada of a Canadian victim of an air disaster who may apply for a Permanent Residence Visa. Use the current version of this form and follow the checklist relevant to your situation.

This form collects personal information and declarations necessary for the application process. Make sure to fill it out accurately and completely to avoid delays in processing your application.

Context & workflow

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This form collects personal information and declarations from extended family members of a Canadian victim of an air disaster. It is a crucial part of the application for a Permanent Residence Visa.

Why this matters

  • Accurate information is vital for processing your application.
  • Missing signatures or required fields can lead to delays.

Who uses it

Applicants required to complete this form for their application package.

When it is used

  • When the checklist for your program/package lists this form.

Failure prevention (how to avoid rework and returns)

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Key cross-checks to do before you submit

  • Family name (as shown on valid Canadian Government ID)
  • Given name(s) (as shown on valid Canadian Government ID)
  • Date of birth (YYYY-MM-DD)
  • Residential address
  • Telephone number

Common issues that cause rework or refusal

  • Missing required fields such as Family name or Date of birth.
  • Missing signature in the declaration section.

Common pitfalls

Common pitfalls
Form Completion Issues
  • Using an outdated version of the form.
  • Inconsistent details across forms and documents.
Signature and Declaration Problems
  • Failing to sign the declaration section.
  • Not reviewing the declarations before signing.

Requirements snapshot

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  • Complete all personal information fields accurately.
  • Provide a valid signature and date.
  • Include contact details such as E-mail address and Telephone number.
  • Ensure all information matches your supporting documents.

Form sections

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  • Reset Form

    Use this option if you need to clear the form and start over.

  • Print Form

    Print the completed form for submission.

  • RESIDENTIAL ADDRESS

    Provide your current residential address.

  • TYPE NAME

    Type your name as it appears on your identification.

  • BUSINESS ADDRESS

    If applicable, provide your business address.

What it asks for

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  • Family name (as shown on valid Canadian Government ID)
  • Given name(s) (as shown on valid Canadian Government ID)
  • Place of birth
  • Date of birth (YYYY-MM-DD)
  • Citizenship
  • Residential address
  • E-mail address
  • Telephone number
  • Country of Citizenship (as shown in travel document)
  • Passport/Travel Document Number (if known)

What you need before you start

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  • The current form downloaded from the official IRCC form page.
  • Family name (as shown on valid Canadian Government ID)
  • Given name(s) (as shown on valid Canadian Government ID)
  • Place of birth
  • Date of birth (YYYY-MM-DD)
  • Residential address
  • Telephone number

Checklist

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  • Download the current IMM 0171 from the official IRCC form page.
  • Save the PDF locally and open it in a compatible PDF viewer.
  • Follow the form’s signature instructions.
  • Complete the form by copying details from your source documents.
  • Cross-check repeated details across your package for consistency.
  • Review the declarations before signing.
  • Follow the program checklist for submission format and supporting documents.

FAQs

Where do I download IMM 0171?

Use the official IRCC form page and confirm you are using the current version.

Is IMM 0171 required for everyone?

Only if your program checklist or the program authorities instructions require it for your case.

Do I need to sign this form?

Yes. Sign and date the declaration section if it appears in the form.

Do I need to sign by hand?

Follow the form instructions. Some IRCC PDF forms require a printed, handwritten signature.

Can I submit an old version?

No. IRCC can return outdated forms. Always use the latest version.

Do I need translations?

Yes, if any supporting documents are not in English or French.

What happens after IMM 0171?

It becomes part of your application package and is reviewed with the rest of your evidence.

What if IRCC asks for additional documents?

IRCC may request additional documents or clarification during processing. Respond by the deadline and keep any new information consistent with the rest of your package.

Important

VisaMind provides informational guidance only and is not a government agency. This is not legal advice. Requirements can change and eligibility depends on your specific facts. If your case is complex or high-stakes, consult a licensed immigration attorney.

Next steps

Requirements vary by nationality, purpose, timeline, and case details. VisaMind turns uncertainty into a sequenced checklist with official source citations.

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