EBBI Humanitarian & Compassionate (H&C) Assessment

How to fill this out: Write dates as Day / Month / Year (e.g. 04 / 07 / 2026). Where a question does not apply, write N/A. Print clearly in block letters. Return by mail, in person, or scan and email to admin@explorebeyondborders.ca. Expected response: 2–3 business days.

1. Personal Information & Current Status

H&C (Humanitarian & Compassionate) applications under IRPA s.25 are exceptional — not a substitute for regular pathways. Answer fully; write N/A where a question does not apply.

Last Name

First Name

Date of Birth (D/M/Y)

Citizenship / Nationality

Email Address

Phone Number

UCI / Client ID (if known)

Province you currently live in (if in Canada)

Currently Living In (In Canada / Outside Canada)

Current Status in Canada (if applicable)

Current Status Expiry Date (if applicable) (D/M/Y)

Date First Arrived in Canada (if applicable) (D/M/Y)

2. Establishment in Canada

IRCC considers how settled you are in Canada — employment, community involvement, language, and compliance with conditions.

Approximate total years lived in Canada (this stay)

Employment history in Canada (employers, dates, NOC if known) — or N/A

Community ties (volunteer, church, school, friends, organizations) — or N/A

Have you filed Canadian income tax returns (if required)?

YesNoNot required to fileNot sure

English / French ability (self-assessment) (Basic / Intermediate / Advanced / fluent / Very limited)

3. Family & Best Interests of Children

IRCC may consider how your situation affects children in Canada — their schooling, stability, and family ties. This is the standard "best interests of the child" review (not a separate program name).

Are there children in Canada whose best interests could be affected by a removal or refusal? YesNo

Marital Status

SingleMarriedCommon-lawDivorced / separatedWidowed

Spouse/partner in Canada? (status if yes)

Dependent children in Canada (ages, status) — or N/A

If yes, briefly explain — or N/A

Other family in Canada (relationship, status) — or N/A

4. Hardship & Risk if Required to Leave Canada

Describe factors that may support an H&C application. Be factual — exaggeration can harm your file.

Would you face significant hardship, risk, or lack of essential services if you had to return to your home country? YesNo

Explain hardship factors (economic, social, medical, family separation) — or N/A

Medical conditions or lack of care in home country — or N/A

Safety, persecution, or discrimination concerns in home country — or N/A

5. Immigration History & Urgent Flags

Urgency — check all that apply:

If yes: contact EBBI urgently before any other application. Call (647) 780-4069 or Atty. Garvida at (416) 638-1529.

Subject to a removal order, departure order, or exclusion order? YesNo

Urgency — check all that apply

Status expires within 30 daysStatus expires within 60 daysStatus expires within 90 daysCurrently out of statusRemoval/deportation date scheduled

Previous H&C application filed? (No / Yes — pending / Yes — approved / Yes — refused)

Refugee claim (past or present)?

NoYes — pendingYes — refused / withdrawnYes — accepted (protected person)

Previous Canadian visa/permit refusals? Briefly describe — or N/A

Other IRCC applications in progress — or N/A

6. Document Status

Check all documents you currently have ready.

Documents ready — check all that apply

Valid passportCurrent permit / status documentEmployment letters / pay stubsTax records / NOAMedical records (if relevant)Police clearance certificate(s)Birth / marriage certificatesChildren's documents (if applicable)Previous refusal / removal lettersPrior H&C submission copy (if any)

Additional Information / Anything Else We Should Know

Client Declaration

I declare that the information provided is true, complete, and accurate to the best of my knowledge. This form is for assessment only, does not constitute legal advice, and does not guarantee any immigration outcome. I have read the Privacy Policy and Legal Notice at explorebeyondborders.ca. I authorize EBBI to share this information with supervising counsel, Atty. George M. Garvida.

☐ I have read and agree to the above declaration

Full name (print)

Signature

Date (D/M/Y)

For EBBI Staff Use Only

Received by

Date received (D/M/Y)

Reference code assigned

Pathway flagged

Online option: explorebeyondborders.ca/immigration-hc-assessment.html · Legal Notice: explorebeyondborders.ca/legal-disclaimer.html

Humanitarian & Compassionate (H&C) Assessment — Client Intake

1. Personal Information & Current Status

2. Establishment in Canada

3. Family & Best Interests of Children

4. Hardship & Risk if Required to Leave Canada

5. Immigration History & Urgent Flags

6. Document Status

Client Declaration