Application for Registration of Child Under the Indian Act

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The PDF Version - Fill & Print is the recommended format which allows applicants to complete this form electronically.

 

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Guidelines for Completion of Application

 

PROTECTED WHEN COMPLETED

The information you provide on this document is collected under the authority of the Indian Act for the purpose of registration under that Act and will be stored in personal information bank number INA/P-PU-110. Personal information that you provide is protected under the provisions of the Privacy Act

Persons wishing to register a child born before April 17, 1985 should complete the following form to the extent possible using these guidelines.

If you fall into one of the following categories, you are entitled to be registered under the Act.

1.  
2. Persons entitled to be registered prior to April 17, 1985.
   
   
3. Women who lost status through marriage to a man who was not a status Indian (s.12(1)(b)).
   
   
4. Children of women referred to in 1 who were enfranchised upon their mother's marriage (s.109(2)).
   
   
5. Children whose mother and whose father's mother did not have status under the Act before their marriage, who lost status at age 21 (s.12(1)(a)(iv) - referred to commonly as the double-mother rule).
   
   
6. Illegitimate children of women with status under the Act whose registration was successfully protested on the ground that their father was a man who did not have status under the Act.
   
   
7. Persons enfranchised upon application by the head of the household (s.109(1) or its predecessor section).
   
   
8. Children of persons listed in 1 to 6 above.
   
   
9. Illegitimate daughters of status Indian men and women without status, born before April 17, 1985.

PART A

Applications are to be signed by both parents or guardians on behalf of minor child or mentally incompetent persons. If only one parent signs, attach a note explaining why the second signature is not available. Guardians must attach a copy of the Court Order granting guardianship. Persons 18 or over applying for themselves are to use the white form entitled APPLICATION FOR REGISTRATION OF CHILDREN UNDER THE INDIAN ACT 83-044E

PART B

If the person on whose behalf you are applying is from categories 2 to 6, you should include the former band number if known and the name of the former band.

The LONG FORM BIRTH REGISTRATION for each child on which the parents' names are indicated is required.

PART C

If you do not know the band number of the parents, leave it blank. It is important however to name the band with which each person is affiliated.

PART D

You should refer to the categories listed above for the wording. Details such as dates of marriage, enfranchisement order or protest should be included, if known.

Application for Registration of Child Under the Indian Act 

Please communicate with me in: Ο English     Ο French

1. 
   

   We make this application as parents or guardians on behalf of the applicant who is under the age of 18 years or is mentally incompetent within the meaning of the Indian Act. We request that the applicant be registered in the Indian Register and, if applicable that his/her name be entered in a Band List, as provided under the Indian Act.

   Signature of both Parents or Guardians

   ___________________________________

   
   

   Date (YYYY-MM-DD)

   ___________________________________

   
   

    

   ___________________________________

   
   

   Date (YYYY-MM-DD)

   ___________________________________

   
   
   If more space is required, enter additional information on a separate sheet of paper and attach it to this form.
   
   
2. 
   

   Family Name of Parent/Guardian of Child

   ___________________________________

   
   

   Given Name(s)

   ___________________________________

   
   

   Mailing Address

   ___________________________________

   
   

    

   ___________________________________

   
   

   Postal Code

   ___________________________________

   
   

   Telephone No. (Daytime)

   ___________________________________

   
   
   
   
   
3. Information about Child
   
   

   Date of Birth (YYYY-MM-DD)

   ___________________________________

   
   

   Family Name

   ___________________________________

   
   

   Given Name(s)

   ___________________________________

   
   

   Family Name of Father of Child

   ___________________________________

   
   

   Given Name(s)

   ___________________________________

   
   

   Date of Birth (YYYY-MM-DD)

   ___________________________________

   
   

   Band No.

   ___________________________________

   
   

   Band Name

   ___________________________________

   
   

   Maiden Name of Mother of Child

   ___________________________________

   
   

   Given Name(s)

   ___________________________________

   
   

   Date of Birth (YYYY-MM-DD)

   ___________________________________

   
   

   Band No.

   ___________________________________

   
   

   Band Name

   ___________________________________

   
   

   Family Name of Paternal Grandfather of child

   ___________________________________

   
   

   Given Name(s)

   ___________________________________

   
   

   Family Name of Paternal Grandmother of Child

   ___________________________________

   
   

   Given Name(s)

   ___________________________________

   
   

   Family Name of Maternal Grandfather of Child

   ___________________________________

   
   

   Given Name(s)

   ___________________________________

   
   

   Family Name of Maternal Grandmother of Child

   ___________________________________

   
   

   Given Name(s)

   ___________________________________

   
   
   
   
   
4. Grounds for Registration

    

    

Mail to:

The Registrar
Indian Registration and Band Lists
Registration, Revenues and Band Governance Branch
Ottawa, Ontario K1A 0H4

INTER 83-044A E 2012-04-01