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Citizenship and Immigration Canada Citoyennet et PROTECTED WHEN COMPLETED - B PAGE 1 OF 1 FEE PAYMENT FORM - FOR SPONSORS OF PARENTS AND GRANDPARENTS This form must accompany your sponsorship application. Applications submitted with incorrect payments will be returned. CALCULATE YOUR FEES Calculate the applicable fees by referring to the table below. Number of persons Amount per person Sponsor x 75 Principal applicant Processing Fee Spouse or common-law partner x 550 Dependent child under 19 unmarried and not in a common-law relationship x 150 financially self-supporting since before the age of 19 due to a physical or mental condition Amount due CAD Total payment Do not include the Right of Permanent Residence Fee in your payment at this stage. CIC will request the fee at a later date in the process. METHOD OF PAYMENT OPTIONS Certified cheque enclosed and complete section A below Credit card complete sections A and B below OR SECTION A - PAYER INFORMATION Name of payer Given name s Surname Name of sponsor if different from payer Name of principal applicant Address of payer No* and Street Apt. /Unit City Province Postal code SECTION B - CREDIT CARD PAYMENT AUTHORIZATION Please indicate the type of credit card with an X I agree to pay the Receiver General for Canada 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 Date YYYY-MM-DD FOR OFFICIAL USE ONLY IMM 5770 08-2014 E Authorization number DISPONIBLE EN FRAN AIS - IMM 5770 F. Number of persons Amount per person Sponsor x 75 Principal applicant Processing Fee Spouse or common-law partner x 550 Dependent child under 19 unmarried and not in a common-law relationship x 150 financially self-supporting since before the age of 19 due to a physical or mental condition Amount due CAD Total payment Do not include the Right of Permanent Residence Fee in your payment at this stage. CIC will request the fee at a later date in the process. METHOD OF PAYMENT OPTIONS Certified cheque enclosed and complete section A below Credit card complete sections A and B below OR SECTION A - PAYER INFORMATION Name of payer Given name s Surname Name of sponsor if different from payer Name of principal applicant Address of payer No* and Street Apt. CIC will request the fee at a later date in the process. METHOD OF PAYMENT OPTIONS Certified cheque enclosed and complete section A below Credit card complete sections A and B below OR SECTION A - PAYER INFORMATION Name of payer Given name s Surname Name of sponsor if different from payer Name of principal applicant Address of payer No* and Street Apt. /Unit City Province Postal code SECTION B - CREDIT CARD PAYMENT AUTHORIZATION Please indicate the type of credit card with an X I agree to pay the Receiver General for Canada VISA on my credit card for fees related to an application MASTERCARD AMERICAN EXPRESS Credit card number for permanent residence.

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