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FEE PAYMENT FORM - APPLICATION FOR PERMANENT RESIDENCE
This form must accompany your application for Permanent Residence under certain programs. Refer to the instruction guide to know if you can use this fee
payment form.
Please refer to step 3 of your instruction guide for acceptable methods of payment. Applications submitted with incorrect payments will be returned.
STEPS TO FOLLOW:
1. Calculate the applicable fee by referring to the fee table below.
Processing Fee
Number of
persons
Amount per person
Amount due
$ CAD
1
for the following applicants: Provincial Nominee Class, Quebec Skilled
Workers, Caring for Children Class and Caring for People
with High Medical Needs Class
x $ 550
Principal applicant
OR
1
Principal applicant
OR
x $ 1050
for the following Business Class applicants: Self-Employed, Immigrant
Investor Venture Capital Class, Quebec Investors, Quebec Entrepreneurs
and Federal Start Up Business
Spouse or common-law partner
x $ 550
Dependent child under 19, unmarried and not in a common-law
relationship
x $ 150
Dependent child aged 19 or older who has been unable to be
financially self-supporting since before the age of 19 due to a
physical or mental condition
x $ 150
DEFINITION OF DEPENDENT CHILD BEFORE AUGUST 1, 2014
Each family member aged 22 or older
x $ 550
Each family member under the age of 22 who is married or in a
common-law relationship
x $ 550
Each family member under the age of 22 who is unmarried and
not in a common-law relationship
x $ 150
Total payment
2. Pay by certified cheque, bank draft or money order payable to THE RECEIVER GENERAL FOR CANADA or by Visa, Mastercard or American Express.
3. Include the payment form and the documents specified in the Document Checklist with your application, specific to the class you are applying under.
4. Check the appropriate box to indicate your method of payment:
Credit card (complete section A and B below)
Certified cheque, bank draft or money order (enclosed and complete section A below)
METHOD OF PAYMENT OPTIONS
A combination of more than one method of payment is acceptable. However, payment by each method MUST be equal to a single or a multiple amount per
person that you have indicated in Step 1 above.
For example: An amount of $550 paid by credit card for the principal applicant, and 2 x $150 paid by a certified cheque for 2 dependents for a total of $850 is
acceptable. However, $500 paid by credit card and $350 by certified cheque will not be accepted.
SECTION A
Name of principal applicant (given name(s), surname)
Name of payer (if different from the principal applicant)
Address of payer (if different from the principal applicant)
SECTION B - CREDIT CARD PAYMENT AUTHORIZATION
I agree to pay the Receiver General for Canada
CAD$
(Please indicate the type of credit card with an "X")
VISA
on my credit card for fees related to an application
MASTERCARD
AMERICAN EXPRESS
Credit card number
for permanent residence.
Note: The amount authorized must be equal to a single fee or a multiple of a single
fee. Authorizations for other amounts are incorrect.
Expiry date of the card
Month
Year
Card security/card verification value code (CVV)
A three (3) or four (4) digit number usually found on the
back or front of the credit card.
Name of cardholder (please print)
Note: The credit card must be valid for at least nine (9) months from the date of
submission of your application. Otherwise your application will be returned.
Signature of cardholder
FOR OFFICIAL
USE ONLY
IMM 5620 (10-2015) E
Date (YYYY-MM-DD)
Authorization number
(DISPONIBLE EN FRANÇAIS - IMM 5620 F)