For office use only
Received on:
Application for an Extension of Time to File or Perfect an Appeal
Subsection 159.91(2) of the Immigration and Refugee Protection Regulations
Rules 6 and 37 of the Refugee Appeal Division Rules
Select one of the following:
Application for an extension of time to file and perfect an appeal:
Refugee Protection Division (RPD) decision: 2024/11/13
_______________________________ ___________________________________
Date of the notice of decision Date RPD reasons received
(yyyy/mm/dd) (yyyy/mm/dd)
Important: Attach three copies of the Notice of Appeal and two copies of the Appellant’s Record. Provide any evidence in support of this application in an
original affidavit or statutory declaration.
Application for an extension of time to perfect an appeal:
Refugee Appeal Division (RAD) file no.: _______________________________
Important: Attach two copies of the Appellant’s Record. Provide any evidence in support of this application in an original affidavit or statutory declaration.
Signature of appellant/ Language Representative
RAD file no.
Appellant RPD file no. designated chosen for designated by
(for office use)
representative appeal RPD
___________________________________________
LAST NAME, first name, middle name(s)
English None
___________________________________________
Date of birth Unique client Date signed
identifier (yyyy/mm/dd) French Yes. Provide
___________________________________________ information
Country of nationality/Country of citizenship on page 3.
___________________________________________
LAST NAME, first name, middle name(s)
___________________________________________ Unique client Date signed English None
Date of birth identifier (yyyy/mm/dd)
French Yes. Provide
___________________________________________ information
Country of nationality/Country of citizenship
on page 3.
___________________________________________
LAST NAME, first name, middle name(s)
___________________________________________ None
English
Date of birth Unique client Date signed
___________________________________________ identifier (yyyy/mm/dd) French Yes. Provide
Country of nationality/Country of citizenship information
on page 3.
___________________________________________
LAST NAME, first name, middle name(s)
None
___________________________________________
Date of birth Unique client Date signed English
identifier (yyyy/mm/dd) Yes. Provide
___________________________________________ French information
Country of nationality/Country of citizenship on page 3.
Disponible en français Immigration and Refugee Board of Canada
http://www.irb-cisr.gc.ca
Application for an Extension of Time to File or Perfect an Appeal
RAD.00 (2017/01) Page 1 of 3
RAD file no.: Unique client identifier:
NOTE: For reasons of fairness and natural justice, the RAD may extend the time limit to file or perfect an appeal.
Provide the detailed reasons for which you require the extension of time on the lines below. You may attach additional sheets of
paper the same size as this form if needed as well as documents to support your request.
Disponible en français Immigration and Refugee Board of Canada
http://www.irb-cisr.gc.ca
Application for an Extension of Time to File or Perfect an Appeal
RAD.00 (2017/01) Page 2 of 3
RAD file no.: Unique client identifier:
Address of appellant
No. and street Apt. no. City Province Postal code
( ) ( ) ( ) ( )
Area code Home telephone Area code Work telephone Area code Home fax Area code Work fax
Counsel contact information
Name (Mr./Ms) Law firm or company
No. and street Apt. no. City Province Postal code
( ) ( )
Area code Telephone no. Area code Fax no. Electronic mail address Membership no.
Lawyer / Paralegal / Notary : _____________________________________
Province
College of Immigration Consultants (CICC)
Family member or other person helping with this appeal: (Please complete the Notice of representation without a fee or other consideration and provide it to the
RAD with these documents.)
Limitation on retainer: _________________________________________________________________________________________________________________________
Note: The Immigration and Refugee Protection Act makes it an offence for any person not authorized under the Act to knowingly, directly or indirectly, represent or advise a
person for consideration – or offer to do so – in connection with a proceeding under this Act. (Consideration includes money, or any other form of compensation or reward.)
I have been retained to represent the appellant(s) named above for their appeal before the RAD.
________________________________________________ ________________________________________________
Signature of counsel Date (yyyy/mm/dd)
Designated representative information
(if one was designated by RPD)
Name (Mr./Ms) Relationship (if applicable) Organization or company (if applicable)
No. and street Apt. no. City Province Postal code
( ) ( )
Area code Telephone no. Area code Fax no. Electronic mail address
Interpreter’s declaration
I, (print full name clearly) _______________________________________________________________, hereby declare that I have accurately interpreted the entire content of
this form to the appellant(s) from the English to the ______________________________________________________________ language (state dialect if applicable). I am
proficient in both these languages (and dialect, if any) and was able to communicate fully with the appellant(s). The appellant(s) indicated that he/she/they fully understand(s)
the entire content of this form as interpreted by me.
_________________________________________________ ________________________________________________
Signature of interpreter Date (yyyy/mm/dd)
Disponible en français Immigration and Refugee Board of Canada
http://www.irb-cisr.gc.ca
Application for an Extension of Time to File or Perfect an Appeal
RAD.00 (2017/01) Page 3 of 3
