2011 Indian Act Amendments - Gender Equity in Indian Registration Act Application for Registration and Secure Certificate of Indian Status - Instructions

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PROTECTED B 


Privacy Act Statement

Personal information provided in this document is collected under the authority of the Indian Act to determine entitlement to inclusion in the Indian Register and, if applicable, in a Band List maintained by the Department of Indian Affairs and Northern Development (DIAND), and to obtain an in-Canada format of a Secure Certificate of Indian Status (in-Canada SCIS). Individuals have the right to the protection of and access to their personal information under the Privacy Act. If registered, DIAND may disclose the applicant's personal information to Health Canada for the provision of non-insured health benefits and/or services, and to a third party for the purpose of printing the in-Canada SCIS. The personal information will be retained indefinitely by DIAND. Details of the collection, use, disclosure and retention of personal information are described in the Personal Information Bank INA PPU 110  .

Section A


INSTRUCTIONS FOR ADULT APPLICANTS (16 YEARS OF AGE OR OLDER)



If ALL three of the following conditions apply to you, you may now be entitled to registration pursuant to the 2011 Indian Act amendments, Gender Equity in Indian Registration Act:

  • your grandmother lost her entitlement to registration as a Status Indian as a result of marrying a non-Indian;

  • one of your parents is/was entitled to be registered pursuant to subsection 6(2) of the Indian Act; AND

  • you, or one of your siblings of the same entitled to be registered parent, was born on or after September 4, 1951.
Note: If your grandparents were not married to each other before April 17, 1985 and your parent was born after April 17, 1985, the 2011 Indian Act amendments may not entitle you to registration.


USE THIS APPLICATION FORM TO APPLY BY MAIL:

  Complete this form and provide the required documents to be registered, and if you are entitled to registration under the Indian Act, to receive the in-Canada SCIS . 

COMPLETE THE ADULT PORTION OF THE APPLICATION FORM:

Complete Parts 1, 2, 3, 4 (required for in-Canada SCIS issuance), and 5 of the form.

  Part 1 Applicant Information - Provide the requested personal information and indicate your band affiliation.

Part 2 Parent Information - Provide the information pertaining to your parent who is/was entitled to be registered under subsection 6(2) of the Indian Act.

Part 3 Grandmother Information - Provide the information pertaining to your grandmother who lost her entitlement to registration as a Status Indian as a result of marrying a non-Indian.

Part 4 In-Canada SCIS Application - Complete Part 4 to receive your in-Canada SCIS  

  • list the documents you are using to support your identity;
  • provide 2 passport-style photographs; and
  • provide a sample of your usual signature.

Part 5 Adult Declaration - If you are 16 years of age or older, you must

  • select the statements that are applicable to your declaration;
  • indicate your language preference for any additional communication; and
  • sign and date the application indicating your agreement with each statement selected.

PROVIDE REQUIRED DOCUMENTS:

Provide the following documents with your application to meet the document requirements:

For Registration:

  1. Your original birth document listing your parents' names (e.g., “Long Form Birth Certificate”) – this is mandatory for processing your application.

  2. Original change of name document(s) or photocopies of marriage or divorce certificates, if applicable, when your name on your application form is different from the name on your birth certificate.

    For in-Canada SCIS issuance: 

  3. An original completed Guarantor Declaration (Form 83-120E);

    Note: The Registration and Secure Certificate of Indian Status Guarantor Declaration (Form 83-120E) is available at www.inac-ainc.gc.ca. for completion and inclusion with your application. Instructions for completing the declaration are included on the form.

  4. Original valid identity document(s) (ID) OR photocopies of both sides of your valid ID(s) each signed by your guarantor. The valid ID(s) used as proof of your identity must show your name, signature and photograph. Provide either:

       
    • one valid ID that shows your name, signature and photograph (e.g., US or Canadian Passport, enhanced driver's license or identity card, NEXUS or FAST card, Federal, Provincial/Territorial or State government-issued ID); OR
    • more than one valid ID that together show your name, signature and photograph.

     
  5. Two identical passport-style photographs taken within the last 12 months, one of which must be signed on the back by your guarantor indicating true likeness of the photograph to you.

    Note: More information on acceptable photographs is available on the INAC website www.inac-ainc.gc.ca..

     
  6. If an eligible guarantor is not available, provide a Statutory Declaration in Lieu of Guarantor (Form 83-119E), one passport-style photograph and photocopy of both sides of your ID, all signed by a Commissioner for Oaths, Notary Public or Lawyer.

    Note: The Registration and Secure Certificate of Indian Status Statutory Declaration In Lieu of Guarantor (Form 83-119E) is available at www.inac-ainc.gc.ca. for completion and inclusion with your application. Instructions for completing the declaration are included on the form.

  General Notes:

If you do not complete all required parts of the application form and provide all the required documents, processing of your application may be delayed.

If you only submit the documents required for registration with this application, if entitled, your name will be included in the Indian Register and from the date that you are notified of being registered, you will have twelve (12) months to provide the outstanding documents required for in-Canada SCIS issuance. If registered, you will be provided with a temporary confirmation document that may be used as proof of your registration and will be valid for twelve (12) months, after which time you will need your in-Canada SCIS to prove that you are registered in order to access certain benefits and services.

Section B


INSTRUCTIONS FOR PARENTS OR GUARDIANS APPLYING ON BEHALF OF CHILDREN
(15 YEARS OF AGE OR YOUNGER) OR DEPENDENT ADULTS


 
Parents or Guardians may apply on behalf of a child (15 years of age or younger) or a dependent adult pursuant to the 2011 Indian Act amendments, Gender Equity in Indian Registration Act , if all three of the following conditions are met:

  • the child's or dependent adult's grandmother lost her entitlement to registration as a Status Indian as a result of marrying a non-Indian;

  • one of the child's or dependent adult's parents is/was entitled to be registered under subsection 6(2) of the Indian Act; AND

  • the child or dependent adult, or one of his/her siblings of the same entitled to be registered parent, was born on or after September 4, 1951.
Note: If the child's or dependent adult's grandparents were not married to each other before April 17, 1985 and the child or dependent adult was born after April 17, 1985, the 2011 Indian Act amendments may not entitle the child or dependent adult to registration.


USE THIS APPLICATION FORM TO APPLY BY MAIL:

  Parents or Guardians are to complete this form in order to register a child or dependent adult and to receive, if the child or dependent adult is entitled to registration under the Indian Act, the in-Canada SCIS .

COMPLETE THE CHILD or DEPENDENT ADULT PORTION APPLICATION FORM:

Complete Parts 1, 2, 3, 4 (required for in-Canada SCIS issuance), and 6 of the attached form.

Part 1 Applicant Information - Provide the requested personal information of the child or dependent adult.

Note: For purposes of the application form, the “Applicant” is the child or dependent adult.

 Part 2 Parent Information - Provide the information pertaining to the child's or dependent adult's parent who is/was entitled to be registered under subsection 6(2) of the Indian Act.

Part 3 Grandmother Information - Provide the information pertaining to the child's or dependent adult's grandmother who lost her entitlement to registration as a Status Indian as a result of marrying a non-Indian.

Part 4 In Canada SCIS Application - Complete Part 4 for the child's or dependent adult's in-Canada SCIS

  • list the documentation used to support the identity of the applying parent or guardian; and
  • provide two passport-style photographs of the child or dependent adult.

Part 6 Parents' or Guardians' Declaration - The parent(s) or guardian(s) applying on behalf of a child or dependent adult must:

  • select the statements that are applicable to the declaration;
  • indicate the language preference for any additional communication;
  • indicate the primary contact (all correspondence will be sent to the primary contact) and provide additional contact information if required; and
  • sign and date the application indicating agreement with each statement selected.

The signature of both parents is required for registration. If only one parent is available to sign, he or she must attach an original Statutory Declaration in Place of Other Parent's or Legal Guardian's Signature or a Court Order granting sole custody or guardianship of the child.

Guardians must attach a copy of the Court Order granting guardianship or trusteeship.

PROVIDE REQUIRED DOCUMENTS:

Provide the following documents with the application to meet the document requirements:

For Registration:

  1. The original birth document of the child or dependent adult listing the names of his/her parents (e.g. "Long Form Birth Certificate") - this is mandatory for processing the application.

  2. Original change of name document(s), if applicable when the name of the child or dependent adult provided on the application form differs from his/her name on the birth certificate (e.g., name change document, Court Order).

  3. Original change of name document(s) or photocopies of marriage or divorce certificates of the applying parent, if applicable, when the parent's name on the child's or dependent adult's long form birth certificate is different from the name of the parent applying on behalf of a child or dependent adult.

  4. Court Order granting guardianship or trusteeship to the applying guardian, if applicable.

    For in-Canada SCIS issuance:

  5. A completed original Guarantor Declaration for the applying parent or guardian.

    Note: The Registration and Secure Certificate of Indian Status Guarantor Declaration (Form 83-120E) is available at www.inac-ainc.gc.ca. for completion and inclusion with the application. Instructions for completing the declaration are included on the form.

  6. Original valid identity document(s) OR photocopies of both sides of the applying parent's or guardian's ID each signed by the guarantor. The ID used as proof of identity must show the name, signature and photograph of the applying parent or guardian.
    Provide either:

    • one valid ID that shows the name, signature and photograph of the applying parent or guardian (e.g. US or Canadian Passport, enhanced driver's license or identity card, NEXUS or FAST card, Federal, Provincial/Territorial or State government issued ID), OR

    • more than one valid ID that together show the name, signature and photograph of the applying parent or guardian.

  7. Two identical passport-style photographs taken within the last 12 months of the child or dependent adult, one of which must be signed on the back by the guarantor indicating true likeness of the photograph to the child or dependent adult.

    Note: More information on acceptable photographs is available on the AANDC website www.inac-ainc.gc.ca.

  8. If only one parent signs the application, provide an original Statutory Declaration in Place of Other Parent's or Legal Guardian's Signature (Form 83-115E) or a Court Order granting sole custody or guardianship.

    Note: The Statutory Declaration in Place of Other Parent's or Legal Guardian's Signature (Form 83-115E) is available at www.inac-ainc.gc.ca. for completion and inclusion with the application. Instructions for completing the declaration are included on the form.

  9. If an eligible guarantor is not available, provide an original Statutory Declaration in Lieu of Guarantor (Form 83-119E), one passport-style photograph of the child or dependent adult and photocopies of both sides of the applying parent's or guardian's ID, all signed by a Commissioner for Oaths, Notary Public or Lawyer.

    Note: The Registration and Secure Certificate of Indian Status Statutory Declaration In Lieu of Guarantor (Form 83-119E) is available at www.inac-ainc.gc.ca. for completion and inclusion with the application. Instructions for completing the declaration are included on the form.

General Note:

Failure to complete all required parts of the application form and provide all the required documents may result in delayed processing of the application.

If you only submit the documents required for registration with this application, if entitled, the applicant's name will be included in the Indian Register and from the date that you are notified that the applicant is registered, you will have twelve (12) months to provide the outstanding documents required for in-Canada SCIS issuance. If the applicant is registered, you will be provided with his or her temporary confirmation document that may be used as proof of the applicant's registration and will be valid for twelve (12) months, after which time the applicant will need his or her in-Canada SCIS to prove that he or she is registered in order to access certain benefits and services.

 

Adult Application Completion Checklist

Confirm that the Adult Application is complete by checking the following items
Check
Applicant Checklist 
 
℘     Applicant information (Part 1) is complete
℘     Parent information (Part 2) is complete
℘     Grandmother information (Part 3) is complete
℘     Identity documents are listed in Part 4
℘     Specimen signature is provided in Part 4
℘     Applicant declaration (Part 5) is completed and signed
The following documents are included with the signed application
℘     Original birth document listing names of parents (mandatory for processing the application)
℘     Original name change documents or photocopies of marriage or divorce certificates if the name on the application form is different from the name on the birth document
℘     Original Guarantor Declaration
℘     Photocopies of identity document(s) signed on the back by guarantor
℘     Original statutory declarations (if required)
℘     Two passport style photographs taken in the last 12 months, one of which is signed on the back by guarantor indicating true likeness of the applicant
℘     Other documents as required

Child or Dependent Adult Application Completion Checklist

Confirm that the Child or Dependent Adult Application is complete by checking the following items
Check
Applicant Checklist 
 
℘     Applicant (child or dependent adult) information (Part 1) is complete
℘     Parent information (Part 2) is complete
℘     Grandmother information (Part 3) is complete
℘     Identity document(s) of applying parent or guardian are listed in Part 4
℘     Parent(s) or guardian(s) declaration (Part 6) is completed and signed
The following documents are included with the signed application
℘     Original birth document listing names of parents (mandatory for processing the application)
℘     Original change of name document(s), if applicable, when the name of the child or dependent adult provided on the application form differs from his/her name on the birth certificate
℘     Original name change documents or photocopies of marriage or divorce certificates of the applying parent if the parent's name on the application form is different from the parent's name on the birth document
℘     Original Guarantor Declaration for the applying parent or guardian
℘     Photocopy of identity document(s) signed by guarantor
℘     Court Order granting guardianship or trusteeship to the applying guardian
℘     Original Statutory Declaration in Lieu of Guarantor (if required)
℘     Original Statutory Declaration in Pplace of Other Parent's or Legal Guardian's Signature (if required)
℘     Two passport-style photographs of the child or dependent adult taken in the last 12 months, one of which is signed on the back by the guarantor indicating true likeness of the child or dependent adult
℘     Other documents as required

INTER 83-114E 2011-01-31