Financial Capability Questionnaire Financial Capability Questionnaire File Information Name * Name First First Last Last Email * Current residential address: * Current residential address: Current residential address: Current residential address: City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Date of birth: * Are you employed? * Yes No What is your position and the name of your employer? * What are your typical weekly/monthly hours? * If you are not employed, why? * What is your annual income? If you are living with someone, what is the household income? * Do you expect to earn more or less than your annual income in the future? If so, why? * How much is your rent or mortgage? * Please break down your monthly budget as accurately as you can (i.e. X on food, X on rent, X on entertainment etc.) * Do you have any savings? Any investments? Please list the amount of your savings and all investments. * Do you own any assets? Please specify. (Home, car etc). * Do you have any insurances? Please specify. (Life, car, disability etc). * Do you receive financial support from anyone? * Yes No Who? How frequently do they send you money and what amount? * Do you have any debt? (Credit card, line of credit, loans etc.) * Do you have children? * Yes No What are the monthly recurring expenses for them? * Do you support anyone else? * Yes No If so, in what capacity? How frequently do you send them money and how much do you send them? Do you have new job prospects or opportunities lined up for the future? If so, will you have an increase in your income? * Do you have short or long-term plans to return to school? If so, what program and where? * Since coming to Canada, have you ever been on social assistance/welfare? * Yes No If so, when? (i.e. from XX - XX). What were the circumstances that lead to your being on social assistance? * How can we best help you? Please indicate any other special information about which you believe would be relevant to us to know pertaining to your case? What is the thing that stresses you the most about your immigration matter? reCAPTCHA If you are human, leave this field blank. Submit
