Transcript SCHEDA ISCRIZIONE/AGGIORNAMENTO AIRE (Anagrafe degli

to: Italian Consulate General in Montreal (tel. +1 514 849-8351)
A.I.R.E. APPLICATION FORM (Registry of Italian Citizens Residing Abroad)
This personal declaration, given in accordance with articles 46 and
47 of D.P.R. n. 445/2000, does not require signature authentication.
a. APPLICANT
The undersigned Italian citizen:
1.
PLEASE PRINT
Given name/s
2.
Date of birth
2.1.
/
Sex
Last name
/
place
dd/mm/yyyy
Current address
Residence in Canada
Apt/Unit
Street no.
Postal code
Tel. home
Tel. work
Prov.
Province/territory
Cellular
Email
5.
Italian municipality (Comune) of reference
6.
If already in AIRE, provide place of previous residence and Italian Consulate/Embassy of registration:
If born in Italy and/or were a resident of Italy, indicate the Italian municipality of last residence
Place of last residence (city, province/territory/state, country)
/
Date of entry in Canada
/
Status
8.
Date of arrival within Montreal’s consular jurisdiction
9.
Other citizenship/s
dd/mm/yyyy
Includes NB, NL, NS, NU, PE, QC
10. Marital status
Canadian citizen/permanent resident/type of visa (expiry date)
/
/
dd/mm/yyyy
Specify whether from birth or from date of naturalization (dd/mm/yyyy)
 single
 common law
 separated  divorced
11.  Marriage/ Civil union
11.1.
/
/
dd/mm/yyyy
 civil union  married
 widow/er
City, province/territory/state, country
If celebrated outside of Italy, provide the Italian municipality (Comune) of registration
Comune of
12. Previous unions
Marital and/or civil
Prov.
City Italian Consulate/Embassy, country
7.
Other than Italian
M
Street name
City
4.
F
Place of birth (city, province/territory/state, country)
If born outside of Italy, provide the Italian municipality (Comune) of registration
Comune of
3.
 
 
Yes No
Divorce
/
/
dd/mm/yyyy
13. Occupation
Prov.
City, province/territory/state, country
Education
Last completed level of education
14. Given names and last names of the parents (provide mother’s maiden name)
Father
Mother
Last name, given name/s
Maiden name, given name/s
b. ATTACHED DOCUMENTATION (I.D. + Proof of Residence are mandatory):




Passport (pages with picture and signature)
Family members passports
Permanent resident card
Visa (indicate type) ______________________
CGIM–M001 DEM EN (R03)
Disponibile anche in italiano (CGIM–M001 DEM IT)
Aussi disponible en français (CGIM–M001 DEM FR)
 Proof of residence within consular jurisdiction
(provincial driver licence, lease contract, utility bill, etc.)
 Other: ______________________________________
CONTINUED ON BACK
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c. FAMILY MEMBERS LIVING AT SAME ADDRESS (ITALIANS AND/OR OTHER NATIONALITY)
Family members 18 and older who are Italian citizens must ALSO fill out an individual form to be attached to
this one.
c.1.
SPOUSE / CIVIL UNION PARTNER / COMMON LAW PARTNER
15.
Given name/s
16. Date of birth
17. Citizenship/s
place
dd/mm/yyyy
F
M
Place of birth (city, province/territory/state, country)
/
/
dd/mm/yyyy
and within Montreal’s consular jurisdiction
/
Includes NB, NL, NS, NU, PE, QC
/
dd/mm/yyyy
CHILD 1
19.
Given name/s
20. Date of birth
21. Citizenship/s
/
Sex
Last name
/
place
dd/mm/yyyy
 
F
M
Place of birth (city, province/territory/state, country)
Specify whether from birth or from date of naturalization (dd/mm/yyyy)
22. Date of entry in Canada
c.3.
 
Specify whether from birth or from date of naturalization (dd/mm/yyyy)
18. Date of entry in Canada
c.2.
Sex
Last name
/
/
dd/mm/yyyy
and within Montreal’s consular jurisdiction
/
Includes NB, NL, NS, NU, PE, QC
/
dd/mm/yyyy
CHILD 2 (for child 3, 4 …, attach an additional sheet)
23.
Given name/s
24. Date of birth
25. Citizenship/s
/
Sex
Last name
/
place
dd/mm/yyyy
 
F
M
Place of birth (city, province/territory/state, country)
Specify whether from birth or from date of naturalization (dd/mm/yyyy)
26. Date of entry in Canada
/
/
dd/mm/yyyy
and within Montreal’s consular jurisdiction
/
Includes NB, NL, NS, NU, PE, QC
/
dd/mm/yyyy
I, the undersigned, fully aware that untruthful statements, forgery and use of false documents, will be prosecuted by law as per article 76 D.P.R. n. 445/2000,
hereby declare that the above information is accurate and true. I hereby also declare to be fully aware that the personal data collected will be used, including in
its digital form, exclusively for the purpose for which this application is submitted, in accordance with D.Lgs n. 196/2003.
Place and date: __________________ , ____/____/______
Signature _______________________________________
dd/mm/yyyy
This application -with all its required documentation- can be delivered in person to the Italian Consulate in Montreal, 3489 Drummond
(corner Dr. Penfield - Metro green line, Peel stop – Bus 144), or can be forwarded by:
Mail
3489 Drummond, Montreal, QC - H3G 1X6 - CANADA
Fax
+1 514 499-9471
For official use only
 Dichiarazione ricevuta per via telematica (ex art 38 D.P.R. 445/2000)
AIRE:  ISCR. / AGG. / TRASF. CIC / ALL.  SÌ  NO
 NUOVA CITT.
Firma dell’impiegato incaricato
Email (total size 5MB max)
[email protected]
SIFC One
 SÌ  NO
MATR/UN CIV  SÌ  NO  ITA
RCI / CRP
 SÌ  NO
DIVORZIO
NAT>15.8.92
 SÌ  NO
 SÌ  NO
__________________________________________
CGIM–M001 DEM EN (R02)
Disponibile anche in italiano (CGIM–M001 DEM IT)
Aussi disponible en français (CGIM–M001 DEM FR)
Data
_____ / _____ / __________
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