Humanitarian & Compassionate (H&C) Assessment

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

Citizenship / Nationality

Email Address

Phone Number

UCI / Client ID (if known)

Province you currently live in (if in Canada)

Currently Living In

Current Status in Canada (if applicable)

Current Status Expiry Date (if applicable)

Date First Arrived in Canada (if applicable)

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)?

English / French ability (self-assessment)

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).

Marital Status

Spouse/partner in Canada? (status if yes)

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

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

Yes No

If yes, briefly explain — or N/A

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

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?

Yes No

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

Immigration History & Urgent Flags

Previous H&C application filed?

Refugee claim (past or present)?

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

Yes No

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

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

Other IRCC applications in progress — or N/A

Urgency — check all that apply:

Status expires within 30 days Status expires within 60 days Status expires within 90 days Currently out of status Removal/deportation date scheduled

Client Declaration

I declare that the information provided in this form is true, complete, and accurate to the best of my knowledge. I understand that H&C assessment is not legal advice, does not guarantee approval, and that IRPA s.25 relief is discretionary. I have read the Privacy Policy and Legal Notice. I authorize EBBI to share this information with supervising counsel, Atty. George M. Garvida, for the purpose of preparing a legal recommendation.

I have read and agree to the above declaration

Type Your Full Name (electronic signature)

Date

Humanitarian & Compassionate (H&C) Assessment