Immigration, Refugees Immigration, Refugies PROTECTED WHEN COMPLETED - B

and Citizenship Canada et Citoyennete Canada Reset Fort(' I

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USE OF A REPRESENTATIVE
You do not need to hire a representative, it is your choice. No one can guarantee the approval of your application. All the forms and information that you need
to apply are available for free at www.cic.gc.ca.

A representative is someone who has provided advice or guidance to you at any stage of the application process, whether that person received consideration
(i.e. compensation) or not. Following the submission of your application, that person may conduct business on your behalf with Immigration, Refugees and
Citizenship Canada (IRCC) and the Canada Border Services Agency (CBSA) if you appoint them as your representative by filling out this form. The preceding
includes Express Entry submissions. You may have one representative only per application. If you appoint an additional representative, the previous
representative will no longer be authorized to conduct business on your behalf and receive information on your case file.

Note: You must use this form to appoint a paid or unpaid representative to conduct business with IRCC or the CBSA on your behalf. You must also use this
form to: 1. notify IRCC if your representative's contact information changes, 2. if you wish to cancel the appointment of your current representative and
represent yourself, or, 3. if you wish to cancel the appointment of your current representative and appoint a new representative
I am:
0 appointing a representative. Complete Sections A, B and D.

El cancelling the appointment of a representative. Complete Section A, C and D.

1. Your full name

Family name (Surname) Given name(s)

Avtar Singh Avtar Singh

2. Your date of birth (YYYY-MM-DD)

1985-07-27

3. If you have already submitted your application:

Name of office where the application was submitted Type of application (permanent residence,extension of study permit, etc.)

4. Unique Client Identifier (UCI) number (if known)

92827739

• I authorize the following individual to serve as my representative and to conduct business on my behalf with Immigration, Refugees and Citizenship
Canada and Canada Border Services Agency. Note: Even if a representative is being paid or compensated by someone other than you (the applicant),
the representative is still considered to be a compensated representative.
• I authorize Immigration, Refugees and Citizenship Canada and Canada Border Services Agency to release information from my case file and that of my
dependent children under 18 years of age to my representative. This authorization is in accordance with the Privacy Act.
• I am aware that any information which would be subject to exemption, if I had the right of access under the Privacy Act or the Access to Information Act,
will likely not be released.
5. Your representative% full name
Family name (Surname) Given name(s)

Brar Navdeep Kaur

6. Your representative (tick one box):

(i) is UNCOMPENSATED and is a

O friend or family member

ri member of the College of Immigration and Citizenship Consultants (CICC), a Canadian provincial or territorial law society, or the Chambre des
notaires du Quebec
Which province or territory? Membership ID number

• other (please specify)

IMM 5476 (11-2021) E (DISPONIBLE EN FRAKAIS IMM 5476 F)

Canada
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OR
(ii) is, or will be, COMPENSATED and is a member in good standing of

i., the College of Immigration and Citizenship Consultants (CICC)

Membership ID number
R534673

a Canadian provincial or territorial law society

Which province or territory? Membership ID number

the Chambre des notaires du Quebec

Membership ID number

7. Your representative's contact information

Name of firm or organization (if applicable)
Pristine Immigration Solutions Inc
If student-at-law, write the name of the supervising. lawyer Supervising lawyer membership ID

Mailing address
A t/Unit Street no. Street name
205 6678 152 Street

City/Town Province/State/Territory Country or territory Postal code/ZIP

Surrey BC Canada V3S 3L4

Telephone number
Country Code Area Code and Telephone number
1 604-783-8847

Fax number
Country Code Area Code and Telephone number
7 1
E-mail address (if applicable)
pristineimmigration@gmail.com

By indicating your representative's e-mail address, you are hereby authorizing Immigration, Refugees and Citizenship Canada to transmit your file and
personal information to this specific email address.
8. Your representative's declaration:
• I declare that the information in Section B is truthful, complete and correct.
• I understand and accept that I am the person appointed by the applicant to conduct business on the applicant or sponsor's behalf with Immigration,
Refugees and Citizenship Canada and Canada Border Services Agency.

Iv .....----- 2024-07-26
Signature of representative Date (YYYY-MM-DD)

SEC E AP OF A REPRESENTATIVE
I withdraw my authorization for this person to serve as my representative, to receive information on my case file and to conduct business on my behalf with
Immigration, Refugees and Citizenship Canada and Canada Border Services Agency.
9. Your representative's full name
Family name (Surname) Given name(s)

Name of firm or organization (if applicable)

IMM 5476 (11-2021) E

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10. Your declaration

• I declare that I have fully and truthfully answered all questions on this form and any attached application (if applicable).
• I also declare that I have read and understood all the statements on this form, having asked and obtained an explanation for every point that was not
clear to me.

Avtar Singh
2024-07-26
Signature of applicant Date (YYYY-MM-DD)

Kamaljit Kaur Basran

elGo>)-uor 2024-07-26
Signature of spouse or common-law partner for sponsorship application Date (YYYY-MM-DD)

Warning! It is a serious offence to give false or misleading information on this form.

Personal information provided on this form is collected by Immigration, Refugees and Citizenship Canada (IRCC) under the authority of the Immigration and
Refugee Protection Act (IRPA) and of the Citizenship Act. The personal information of the applicant is used for identification and authorization purposes. The
personal information of the immigration representative is used to verify that the representative is authorized to offer representation services according to the
provisions of IRPA and of the Citizenship Act.

The personal information of both the applicant and the representative may be disclosed to other federal government institutions, non-governmental and inter-
governmental organizations, regulatory bodies, investigative bodies, and provincial/territorial governments for the purposes of validating identity, information,
and supporting an investigation.

Personal information of both the applicant and the representative may be used for other purposes including research, statistics, program and policy evaluation,
internal audit, compliance, risk management, strategy development and reporting.

Failure to complete the form in full will result in a delay to processing. The Privacy Act gives individuals the right of access to, protection, and correction of
their personal information. If you are not satisfied with the manner in which IRCC handles your personal information, you may exercise your right to file a
complaint to the Office of the Privacy Commissioner of Canada. The collection, use, disclosure and retention of your personal information is further described
in IRCC's Personal Information Bank - IRCC PPU 013, 042, 054, 068.

IMM 5476 (11-2021) E