General information Who should complete this application ...

A-0524-BA(2021-05)

A-0524-BA (2021-05) of 5

Ministère de l’Immigration, de la Francisation et de l’Intégration

General information

Who should complete this application?

Under the Pilot program for workers in the artificial intelligence, information technologies and visual effects sectors – (PP AI/IT-VE) – IT-VE Stream, you can apply for permanent selection as a skilled worker if you intend to settle in Québec for a job that you are likely to hold in the information technologies or visual effects sectors.

You may submit only one Application for permanent selection as a principal applicant and, as applicable, for your legal or de facto spouse and accompanying dependent children.

How to proceed

You must complete Parts 1 and 2 of the Application for permanent selection – Pilot program for workers in the artificial intelligence, information technologies and visual effects sectors (PP AI/IT-VE) – IT-VE Stream. Refer to the General Information section.

Make sure you have signed and dated all forms and declarations and keep a copy of the documents you submit to the Ministère de l’Immigration, de la Francisation et de l’Intégration.

Prepare your documents

A list of documents to be submitted to Arrima in support of your application can be found in Part 2 of the Application for permanent selection – Pilot program for workers in the artificial intelligence, information technologies and visual effects sectors (PP AI/IT-VE) – IT-VE Stream. For each of the required documents, scan all pages of the original document in colour into one PDF format file (Portable Document Format). Make sure they remain legible, complete and accurate.

Create an account in Arrima

First, you need to create an account in Arrima. If you already have an Arrima account, please log into it.

Submit your Application for permanent selection in Arrima

The steps of this process are as follows:

1. Provide information about accompanying family members.

2. Upload your application form for permanent selection and submit the required documents to support your application.

3. Pay the fees due.

4. Submit your application.

Once your application is submitted, you will receive a message in Arrima confirming its receipt.

Application form for permanent selectionPilot program for workers in the artificial intelligence, information technologies and visual effects sectors (PP AI/IT-VE) – IT-VE Stream

Ministère de l’Immigration, de la Francisation et de l’Intégration A-0524-BA (2021-05) of 5

Selection criteria

In order to be issued a Certificat de section du Québec (Québec selection certificate) under the PP AI/IT-VE – IT-VE Stream, you must be a worker in the information technologies and visual effects sectors. You must:

• Intend to settle in Québec for an eligible job in the information technologies or visual effects sector that you are likely to be able to perform;

• Hold or have accepted an eligible full-time job in Québec for which the hourly wage is greater than the ninth decile of the average hourly wage for the last three years available for this job, as estimated by the Minister of Employment and Social Solidarity;

• Hold a diploma equivalent to at least a Québec diploma of technical college studies or a Québec university diploma recognized as a Québec Bachelor’s degree;

• Have held an eligible job full time, for a period of at least 24 months within the 60 months following the filing date of the application;

• Demonstrate your knowledge of the democratic values and the Québec values expressed by the Charte des droits et libertés de la personne;

• Francophone profile: Demonstrate knowledge of spoken French at a level equal to or higher than level 7 on the Échelle québécoise des niveaux de compétence en français des personnes immigrantes adultes (Québec scale of proficiency levels in spoken French for adult immigrants) or its equivalent;

• Francization profile: To commit to begin francization from the moment of selection;

• Commit to providing for your basic needs and, where applicable, those of your legal or de facto spouse and dependent children included in your Application for permanent selection, for a minimum period of 3 months;

• Hold a valid passport at the time of application;

• Be at least 18 years old.

If you have a work permit as an accompanying spouse, you may apply and be selected if you meet the conditions listed.

For more information on immigration to Québec, visit the Ministry’s website at https://www.quebec.ca/immigration.

If you wish to apply for permanent selection to the Pilot program for workers in the artificial intelligence, information technologies and visual effects sectors – Artificial intelligence stream (PP AI/IT-VE), you must use the Application for Permanent selection – Pilot program for workers in the artificial intelligence, information technologies and visual effects sectors (PP AI/IT-VE) – AI Stream (A-0524-AA).

Important

The Ministry may require you to attend an interview to verify that you meet the program’s selection requirements. You must notify the Ministry of any changes to the answers on your application form within 30 days of the change.

Please note that originals of the documents you submit may be required at any time during the application process, especially during an interview.

If your application is successful, you will be required to maintain the conditions required for this decision. The Minister may rescind a decision where the conditions required for a favourable decision no longer exist.

Attestation of learning about the democratic values and the Québec values expressed by the Charte des droits et libertés de la personne (Charter of Human Rights and Freedoms)

The attestation of learning about democratic values and Québec values expressed by the Charter of Human Rights and Freedoms must be submitted to the Ministry on request. At the appropriate time, a communication will be sent to your Arrima account, inviting you to obtain the Attestation of learning about democratic values and Québec values. As of that date, you will have, in accordance with the Québec Immigration Regulation (Québec Immigration Regulations*(CQLR, chapter I-0.2.1, r.3), sixty days to obtain an attestation of learning about democratic values and Québec values. Depending on your residency permit, you can take the online assessment in one of two ways or attend the Objectif Intégration information session.

https://www.quebec.ca/immigration


For more information, please refer to the Ministry’s web pages:

• Attestation of learning about democratic values and Québec values: https://www.immigration-quebec.gouv.qc.ca/en/immigrate-settle/attestation-values/index.html;

• Objective: Integration: https://www.immigration-quebec.gouv.qc.ca/fr/region/sessions-information/objectif-integration/index.html.

Once you have successfully completed the online evaluation or attended the Objectif Intégration information session, your attestation of learning about democratic values and Québec values will be automatically sent to the Ministry.

Translation

If you are submitting documents or parts of documents in a language other than English or French, you must provide:

• the document in the original language;

• a full translation by a recognized translator. For translation requirements and the definition of a recognized translator, visit our website at http://www.immigration-quebec.gouv.qc.ca/en/informations/document-requirements.html

If the original document is in English or French, and has an official stamp in another language, you must have the official stamp translated.

Use of a fee-paying service provider

The form and instructions have been designed to allow people wishing to immigrate to Québec to complete their application without assistance. Therefore, it is not necessary to use a fee-paying service provider to take steps on your behalf.

If you decide to use a fee-paying service provider, you should be aware that the only people authorized to provide paid advice, assistance or representation for you in your application are:

• members in good standing of the Barreau du Québec or the Chambre des notaires du Québec.

• persons holding a special authorization issued by the Barreau du Québec or the Chambre des notaires du Québec;

• immigration consultants recognized by the Ministry and registered in the Québec Register of Immigration Consultants (http://www.mifi.gouv.qc.ca/fr/reglementation-consultants/index.html).

You must declare any person who is advising, assisting or representing you in this application, whether or not that person is providing fee-paying services. A person may be considered to provide fee-paying services even if he or she is not directly or indirectly paid by you. This person is considered to be paid if their services are provided as part of a professional service (e.g. immigration consulting services or a labour recruitment agency, etc.).

You may also be represented by any person other than those listed above, but that person may not provide fee-paying services.

Power of attorney

If you wish to have someone represent you before the Ministry, that person must be the holder of an Arrima account and hold a power of attorney established with yourself.

https://www.immigration-quebec.gouv.qc.ca/en/immigrate-settle/attestation-values/index.html

https://www.immigration-quebec.gouv.qc.ca/en/immigrate-settle/attestation-values/index.html

http://www.immigration-quebec.gouv.qc.ca/en/informations/document-requirements.html

http://www.mifi.gouv.qc.ca/fr/reglementation-consultants/index.html

http://www.mifi.gouv.qc.ca/fr/reglementation-consultants/index.html


Definitions

Échelle québécoise des niveaux de compétence en français des personnes immigrantes adultes (Québec scale of French proficiency levels for adult immigrants)

Common standard used in Québec to evaluate language skills and the teaching of French to educated immigrants.

You can consult the content of this scale on the Ministry’s website at the following address: https://www.immigration-quebec.gouv.qc.ca/en/partners/francization-partners/common-frame-reference.html

Family member

In relation to a person:

• his or her legal or de facto spouse;

• the dependent child of that person or of his or her legal or de facto spouse and, as applicable, the dependent child of that child.

Spouse

A married person of at least 16 years of age who:

• was not, at the time of marriage, married to another person;

• is not the legal or de facto spouse of another person while living apart from a person to whom they have been married for at least one year.

Legal or de facto spouse

A person at least 16 years of age who is in one of the following situations:

• has been living in a marital relationship for at least one year with a person of the opposite or same sex who is at least 16 years old;

• has been in a marital relationship for at least one year with such a person, but who, because of persecution or some form of penal control, is unable to live with that person.

Dependent child

In relation to a person, the child of whom this person is the biological father or mother and who has not been adopted by a person other than the legal or de facto spouse of his or her parent, or an adopted child of whom that person is either of the adoptive parents.

This child is in one of the following situations:

• is under 22 years of age and not a legal or de facto spouse;

• is at least 22 years of age and has been substantially dependent on the financial support of a parent since before the age of 22 and is unable to provide for themselves due to a physical or mental condition

The child of a dependent child is included in this definition.

National Occupational Classification

The National Occupational Classification (NOC) is a system used to detail occupations in Canada and Québec. It provides a standardized description of 500 occupations and the nature of the work each covers (https://www.canada.ca/en/immigration-refugees-citizenship/services/immigrate-canada/express-entry/eligibility/find-national-occupation-code.html) .

https://www.immigration-quebec.gouv.qc.ca/en/partners/francization-partners/common-frame-reference.html

https://www.immigration-quebec.gouv.qc.ca/en/partners/francization-partners/common-frame-reference.html

https://www.canada.ca/en/immigration-refugees-citizenship/services/immigrate-canada/express-entry/eligibility/find-national-occupation-code.html

https://www.canada.ca/en/immigration-refugees-citizenship/services/immigrate-canada/express-entry/eligibility/find-national-occupation-code.html


Eligible job

An eligible job means one of the following occupations, according to the National Occupational Classification, with the conditions associated with it, as applicable:

a. Information systems analyst and consultant (code 2171);

b. Graphic designer and illustrator (code 5241), but only if it is practised in the visual effects sector;

c. Computer and information systems manager (code 0213);

d. Software engineer and designer (code 2173);

e. Electrical and electronics engineer (code 2133);

f. Producers, directors, choreographers and related occupation (code 5131), but only if it is practised in the visual effects sector;

g. Computer programmer and interactive media developer (code 2174);

h. Audio and video recording technician (code 5225), but only if it is practised in the visual effects sector;

i. Computer network technician (code 2281);

j. Electrical and electronics engineering technologist and technician (code 2241).


A-0524-BA(2021-05)

Ministère de l’Immigration, de la Francisation et de l’Intégration A-0524-BA (2021-05)Page 1 of 17

Part 1

Complete all sections below, referring to the General Information pages as required. If you run out of space, use a separate page and write the number of the corresponding section on it.

Except for the optional sections, any refusal to answer or an omission may result in the rejection of your application or delays in processing your application.

1. Information about your identity

Sex Female Male

Last name(s) at birth First name(s)

Last names after marriage (as applicable) Other name(s) you use or are known by (as applicable)

Period of validity: Start date (year/month/day) End date (year/month/day)

Citizenship Date of birth (year/month/day)

Place of birth

City Province or State Country or territory

2. Marital status

Single Married Legal or de facto spouse Separated Divorced Annulled marriage Widowed

Have you been married more than once? Yes No

3. Home address

Number Street Apartment City

Province or State Postal code Country or territory

Home phone Work phone Other phone

4. Legal or de facto spouse (as applicable)

You must declare your legal or de facto spouse, whether or not they are included in your Application for permanent selection.

Identity of your legal or de facto spouse

Sex Female Male

Click here for the steps to follow

Please enter your first and last names in block letters as they

appear in your passport.

If you more than one passports, provide the information on

the passport you used to enter the country.

Passport number

See the Definitions section in the General Information.

Enter the address where you are currently living.

See the Definitions in the General Information section.


Last name at birth First name(s)

Last name after marriage (as applicable) Other names you use or are known by (as applicable)

Period of validity: Start date (year/month/day) End date (year/month/day)

Citizenship Date of birth (year/month/day)

Email

Place of birth

City Province or State Country or territory

Would you like to include your legal or de facto spouse in your Québec Application for permanent selection?

Yes No

Home address of your legal or de facto spouse, if different from yours

Number Street Apartment City

Province or state Postal code Country or territory

Home phone Work phone Other phone

5. Dependent children (if any)

Identification of your dependent children

You must declare all your dependent children and indicate for each of them whether or not they are included in your Application for permanent selection, whether they are in Québec or abroad.

Last name at birth

First name(s) Relationship Date of birth (year/month/day)

Place of birth (city/country or territory) Citizenship

Included in your

application

Yes No

6. Linguistic profile

Under which profile would you like to submit your Application for permanent selection?

Francophone profile Francization profile

Indicate the surname(s) and given name(s) as they

appear on the passport used to enter Canada.

Passport number

You must indicate their personal email address

If you are applying for a Québec selection certificate for your

legal or de facto spouse, you must check «Yes» and

complete the declaration of a spouse (p. 12) or legal or

de facto spouse (p. 13).

See the Definitions in the General Information section.

If you are applying for a Québec selection certificate for a child,

you must check “Yes”.

If you wish to submit your Application for permanent

selection under the Francophone profile, please

sign the declaration on knowledge of spoken French.

If you wish to submit your Application for permanent

selection under the Francization profile, don’t forget to sign

the commitment.


7. Education

Official title of diploma:

Issuing authority Province Country

Studies started on Studies successfully completed on

8. Eligible job in the information technologies and visual effects sector in Québec

Do you hold or have you accepted an eligible job in the information technologies or visual effects sector in Québec?

Yes No

If yes, please complete the information below:

Name of the company Title of the job held NOC code

Workplace address

Main duties:

Number of hours worked per week: hrs

Do you have an hourly wage greater than the ninth decile of the average hourly wage for the last three years available for this job, as estimated by the Minister of Employment and Social Solidarity?

Yes No

If yes, enter the amount of your hourly wage: Currency:

You must indicate your highest level of education.

(year/month/day) (year/month/day)


9. Work experience

Enter all the paid eligible jobs held full time during the last 60 months before filing your application. If necessary, use an additional page.

Do any of the following statements apply to your situation?

I have acquired at least 24 months of full-time work experience in the 60 months preceding the date of submitting my Application for permanent selection in an eligible job.

Yes No

From (year/month/day)

To (year/month/day) Name of the company

Title of the eligible

job held

Place of employment (city, country)

Number of hours worked

per week

1. hrs

2. hrs

3. hrs

4. hrs

5. hrs

Main tasks accomplished as part of your role, beginning with the most recent. If necessary, use an additional page:

Main tasks accomplished in the course of your duties NOC code

1.

2.

3.

4.

5.

During the 60 months preceding the submission of your Application for permanent selection, were you self-employed or working on behalf of a company of which you have full or partial ownership or control?

Yes No

If yes, specify:

Title of the job held

Company name Québec Enterprise Number

Period worked Start date (year/month/day) End date (year/month/day)

As applicable, you may indicate the full-time work experience

gained under a post-graduation work permit or a youth

exchange program.

Enter, in full and without abbreviation, the name of

the business that hired you or which you own in whole

or in part. If necessary, use an additional page.

Enter all full-time employment during the

60 months preceding the filing date of this application.

Self-employment or work on behalf of a business you

own, in whole or in part, are not considered

under the PP AI/IT-VE.

If necessary, add an additional page.


10. Current situation

Worker residing abroad

Temporary Foreign Worker in Canada

Holder of a work permit under a youth exchange program (e.g. Working Holiday Permit, Young Professionals Permit or International Co-op Permit)

Holder of a work permit as accompanying spouse

Other (specify):

Are you in compliance with the conditions of your stay in Québec relating to the issuing of your work permit, and, if applicable, of your Québec Certificate of Acceptance? Yes No

If no, please indicate why:

11. Previous application

Have you ever presented:

an Application for temporary residency in Canada? Yes No Province Date (year/month/day)

Accepted Refused Waiting for a decision

an Application for permanent immigration Yes No Province Date (year/month/day)


an Application for asylum in Canada? Yes No Province Date (year/month/day)


an Application for permanent immigration Yes No Accepted Refused Waiting for a decision

In which program?

Regular program PEQ

Pilot program for food processing workers

Pilot Program for patient attendants

Pilot program for workers in the artificial intelligence, information technologies and visual effects sectors

Other

12. Location of the establishment

In which city or region of Québec would you like to settle?

Check the box corresponding to your current situation.

to Canada?

for Québec?


13. Information about the Pilot program for workers in the artificial intelligence, information technologies and visual effects sectors

How did you obtain your information about the pilot program for workers in the artificial intelligence, information technologies and visual effects sectors?

At an information session or webinar organized by Québec government representatives abroad

As part of a «Québec Days» recruitment drive

On the website of the Ministère de l’Immigration, de la Francisation et de l’Intégration du Québec

During promotion activities in Québec

14. A person who provides fee-paying advice, assistance or representation in connection with your application

Do you have recourse to a person who provides fee-paying advice, assistance or representation for you? Yes No

If so, is it

• a lawyer, member of the Barreau du Québec? Yes No

• a notary member of the Chambre des notaires du Québec? Yes No

• a person holding special authorization issued by the Barreau du Québec or the Chambre des notaires du Québec? Yes No

• by an immigration consultant? Yes No

• by another person providing services for a fee? Yes No

Last name Given Name(s)

Registration number

15. Declaration on knowledge of spoken French – Francophone profile only

I confirm that I am generally able to communicate and that I can understand what I hear without help:

• in conversations or presentations in standard French at normal speed;

• when the situation is predictable or partly predictable, i.e. when only certain aspects of the exchange can be planned or anticipated;

• on concrete topics related to current needs, i.e. topics dealing with practical, utilitarian or material aspects;

• in informal conversations or presentations, i.e. in an informal setting or discussion.

Examples of situations or tasks requiring communication and comprehension in French:

• Answer questions about my work experience, education and career plans in a comprehensive manner;

• Outline the advantages and disadvantages of two situations, events or contexts;

• Write a report or a summary based on a current event;

• Distinguish the main concepts of familiar topics in presentations with or without visual aids, if the language is clearly articulated (TV show, radio, lectures, etc.);

• distinguish most of the important facts or events from conversations about common factors regarding work or leisure activities;

• Recognize humour in conversation.

You can check several boxes.

No priority or special treatment is given when you engage a person providing fee-paying

services. All the candidacy files are treated in the same way.

You must identify the person by checking the appropriate

box and entering the requested information.

If an immigration consultant or other person provides

fee-paying services, indicate the name(s) and registration

number as they appear in the Québec Register of

Immigration Consultants.

Please remember to read, sign and date this statement.

You can consult the detailed description of the levels in the

Échelle québécoise des niveaux de compétence en français des personnes immigrantes adultes in oral communication and oral

comprehension on the Ministry’s website at https://cdn-contenu.

quebec.ca/cdn-contenu/francisation/MIFI/referentiel/

NM_echelle_niveaux_competences.pdf.

https://cdn-contenu.quebec.ca/cdn-contenu/francisation/MIFI/referentiel/NM_echelle_niveaux_competences.pdf






I understand that:

• this description corresponds to level 7 of the Échelle québécoise des niveaux de compétence en français des personnes immigrantes (Québec scale of proficiency in spoken French for adult immigrants) and I declare that my French skills reach this level;

• the Minister may require at any time that my knowledge of spoken French be verified or assessed by interview;

• the result of the Minister’s examination determines whether my knowledge of spoken French meets the selection requirement for knowledge of spoken French.

In witness whereof, signed at

City Country or territory Date (year/month/day)

Signature of the principal applicant

16. Declaration of my intention to learn French – Francization profile only

I understand that French is the common official language in Québec. Thus, being able to communicate in French is necessary to promote my socio-professional integration and my full participation in Québec society.

I also understand that I am applying for permanent selection under the Francization profile. I hereby agree to be registered with Accompagnement Québec if I am selected as a skilled worker under the Pilot Program for Permanent Immigration of workers in the artificial intelligence, information technologies and visual effects sectors.

After my registration, I agree to be contacted by an integration agent to identify my francization and integration needs.

I declare that:

• I have read the information in this section and I am committed to learning French;

• I will start learning French, at the latest, as soon as I arrive in Québec.



Signature of the applicant

To help me learn French, the Québec government can offer

me free courses in French. Financial assistance is

available for these courses, under certain conditions.

This person will tell me about the services offered by the

Québec government to learn French. They will be able to assist me in my registration

and in the pursuit of my learning of French.

You can also obtain information on the resources offered by

consulting the following pages:

Learning French: https://www.quebec.ca/en/

education/learn-french

Accompagnement Québec: Quebec.ca/immigration/integration-service-for-

immigrants

https://www.quebec.ca/en/education/learn-french

https://www.quebec.ca/en/education/learn-french

https://www.quebec.ca/en/immigration/integration-service-for-immigrants




17. Attestation of learning about Democratic Values and Québec Values as expressed in the Charte des droits et libertés de la personne (Charter of Human Rights and Freedoms)

Québec is a French-speaking democratic nation that welcomes immigrants from around the world.

In Québec, everyone must respect the law. Every Quebecer enjoys the rights and freedoms recognized by the Charter of Human Rights and Freedoms and other laws, which express the values of Québec society.

The Québec National Assembly, in 2019, adopted the Loi sur la laïcité de l’État (the Act respecting the laicity of the State) to affirm that the Québec State is secular.

Québec society is also governed by the Charte de la langue française (Charter of the French Language), which makes French the official language of the State and of the law, as well as the normal and usual language of work, education, communications, commerce and business.

Learning the democratic values and Québec values expressed in the Charter of Human Rights and Freedoms is a first step towards the successful integration of immigrants. The main values on which Québec society is based are the following:

• in Québec, women and men are equal;

• Québec is a free and democratic society;

• Québec is a secular society;

• Québec is a French-speaking society.

• Québec is a society based on the rule of law;

• Québec is a society where the exercise of human rights and freedoms must be done respecting the rights and freedoms of others and in consideration of general welfare;

• Québec is a pluralistic society.

Québec is committed to supporting and accompanying immigrants in their integration and to promote their full participation in Québec society in French. Immigrants undertake to acquire the skills necessary to participate in Québec society, in particular to learn the French language and to use it in the public sphere, to know and respect the democratic values and Québec values expressed in the Charter of Human Rights and Freedoms, and to participate in the development of Québec culture and the vitality of its official language.

DECLARATION

I UNDERSTAND the scope and meaning of the foregoing and

I AGREE to respect the democratic and Québec values expressed in the Charte des droits et libertés de la personne.

I DECLARE that I wish to live in Québec within the framework of and respect for its democratic values and the Québec values expressed in the Charte des droits et libertés de la personne and that I wish to learn French, if I do not already speak it.

Signature of the principal applicant Date (year/month/day)

Signature of legal or de facto spouse Date (year/month/day)

Signature of dependent child 18 years or older Date (year/month/day)





18. Protection of your personal information

The personal information collected on this form and, as applicable, the documents attached to it, are necessary for the processing of your Application for permanent selection and in application of the Québec Immigration Act, the Québec Immigration Regulation, the Regulation respecting immigration consultants, and the administrative rules, guides and procedures that result. This information may also be used by the Ministry for research, statistical purposes, program evaluation, or to communicate to you any information that may affect your application.

Your personal information will be treated as confidential and will only be accessed by those persons who are entitled to it and for whom it is necessary in performance of their role. However, certain information may be disclosed or obtained without your consent in accordance with the exceptional provisions of the Act respecting access to documents held by public bodies and the protection of personal information, or under inter-agency agreements pursuant to that Act.

Except for the optional sections, any refusal to answer or an omission may result in the rejection of your application or delays in processing your application.

You have the right to be informed of the information the Ministry holds about you, to access it or to request a correction by contacting the person responsible for access to documents and protection of personal information. To find out how to access your personal information, please visit the Ministry’s website at http://www.mifi.gouv.qc.ca/fr/ministere/acces-protection-info/index.html.

19. Declaration of the principal applicant

I declare that:• the information contained in this application and, as applicable, the attached documents, is complete and accurate and

that I will notify the Ministry of any changes to the answers provided in this application within 30 days of such changes;• I wish to settle in Québec to work as a skilled worker;• to have complied with all the conditions of my residency;• accept the financial burdens associated with my establishment and, as applicable, those of my legal or de facto spouse and

dependent children included in my Application for permanent selection.

I acknowledge that I have read the privacy notice in the previous section.

I understand that the Minister can:• audit or have a third party audit the accuracy of the information provided and, in the event that I communicate to the

Ministry any information that I know or should have known to be false or misleading in relation to an Application for selection, I understand that I am committing an offence under the Québec Immigration Act and that I am liable to a fine;

• reject any application that contains false or misleading information or content or on public policy grounds;• refuse to consider or reject an application from a person who has provided, in the five years previously, false or misleading

information or documents in connection with an application under the Québec Immigration Act or who has been the subject of a decision made in the public interest;

• set aside a decision if it was made on the basis of an application that contains false or misleading information or material, if it was made in error, or if the conditions required for a favourable decision have ceased to exist, or if the public interest so requires;

• summon me for an interview to demonstrate the veracity of my statements, to provide any information or documents that he or she considers relevant, or to establish the authenticity, integrity or validity of the documents contained in my application.





http://www.mifi.gouv.qc.ca/fr/ministere/acces-protection-info/index.html

http://www.mifi.gouv.qc.ca/fr/ministere/acces-protection-info/index.html


20. Financial Self-Sufficiency Contract

The Financial Self-Sufficiency Contract is a legal document by which you undertake to provide for your essential needs and, as applicable, those of the persons accompanying you to Québec, namely your legal or de facto spouse and your dependent children, including, as applicable, those who are Canadian citizens. The term of the contract is three months and starts from the date you obtain permanent residency.

The basic needs covered by the contract include, but are not limited to, food, shelter, clothing, and any other personal needs.

As required by the Québec Immigration Regulation, you must subscribe to this contract, failing which your Application for permanent selection will not be accepted.

Before signing the commitment, you must indicate the amount of money you will have available in Québec to support yourself and your companions, if any.

Important

Depending on whether or not your legal or de facto spouse and dependent children are accompanying you, you must use a different scale (see page 10 of 16) to calculate the minimum amount of money you must have available to support yourself and the people accompanying you for the first three months after becoming a permanent resident.

Commitment

I have read the information contained in the Financial Self-Sufficiency Contract and understand the nature and scope of this agreement.

• Accordingly, I declare that I will have, for the duration of this contract, which is three months from the date of obtaining permanent residency, sufficient financial resources to support myself and the persons accompanying me, as required by the Québec Immigration Regulation, namely the sum of Canadian dollars.

• I agree to provide for my basic needs and those of the persons included in my Application for the duration of this contract.

• I authorize the Minister to transmit to the Ministère du Travail, de l’Emploi et de la Solidarité Sociale the information relating to this contract, in the event that an Application for last-resort financial assistance is submitted for me or for one or more of the persons included in my application.

• I agree to reimburse the Gouvernement du Québec for any amount granted under last-resort financial assistance to me or to the persons included in my application, in accordance with the applicable legislation, for the duration of the contract.





You must enter here the amount of money you will

have available in Québec to support yourself and the people

accompanying you, if any. Refer to the current fee scale on the next page.


Scale in effect from 1 January to 31 December 2021

Adults without children

Situation Scale in $CA

1 adult (principal applicant) $3,284

2 adults (principal applicant and accompanying spouse) $4,816

Adult(s) with accompanying dependent child(ren)

Number of dependent children Scale in $CA

1 adult (principal applicant)

– 1 child under 18 years old $4,413

– 2 children under 18 years old $4,981


– More than 3 children under 18 years old: add $568 per child

2 adults (principal applicant and accompanying spouse) and Scale in $CA

– 1 child under 18 years old $5,395



– More than 3 children under 18 years old: add $428 per child

– 1 child (or more) 18 years and older: add $1,531 per child

Example calculations

Adult(s) and number of accompanying dependent children Amount required Total

1 adult and 4 children under 18 years old$5,549

+ $568$6,117

2 adults and 3 children under 18 years old $6,251 $6,251

2 adults and 2 children 18 years and older $4,816 + ($1,531 x 2) $7,878


21. Declaration of Spouse(s)

Declaration of the principal applicant

I, , declare that I am the spouse

of .

Yes No At the time of my marriage to this person, I was the spouse of another person.

Yes No I have a spouse and have been living apart from my spouse since .




Declaration of the spouse accompanying the principal applicant

I, , declare that I am the spouse

of .

Yes No At the time of my marriage to this person, I was the spouse of another person.

Yes No I have a spouse and have been living apart from my spouse since .



Signature of spouse included in this application


First name and last name


Please indicate if the statement applies to you.

Date (year/month/day)



Please indicate if the statement applies to you.



22. Declaration of legal or de facto spouse

Declaration of the principal applicant

I, , declare that

Yes No I live in a marital relationship and cohabit with

since .

Yes No I am in a marital relationship with

since the , but, being the object of persecution or penal control, we can no

longer live together.




Declaration of legal or de facto spouse accompanying the principal applicant

I, , declare that

Yes No I live in a marital relationship and cohabit with

since .

Yes No I am in a marital relationship with

since the , but, being the object of persecution or penal control, we can no

longer live together.



Signature of legal or de facto spouse included in this application

Do not forget to read, sign and date this declaration.


Please indicate if the statement applies to you. First name and last name





Please indicate if the statement applies to you. First name and last name





A-0524-BA(2021-05)


Part 2

Check the box for each document you are submitting. You must attach this completed list to your Application for permanent selection and provide photocopies of the original versions of all requested documents, upload them to Arrima, or your application will be rejected.

For the Ministry’s documentation requirements for translation, see the “Translation of Documents” section on the following page: http://www.immigration-quebec.gouv.qc.ca/en/informations/document-requirements.html.

• Please note that originals of the documents you submit may be required at any time during the application process, especially during an interview.

• For each of the required documents, scan all pages of the original document in colour into one PDF format file (Portable Document Format). Make sure they remain legible, complete and accurate.

• All uploaded documents must be in English or French or accompanied by a translation into English or French signed by a qualified translator.

Forms and declarations

Application for permanent selection Required document

1 • Application form for permanent selection – Pilot program for workers in the artificial intelligence, information technologies and visual effects sectors (PP AI/IT-VE) – IT-VE Stream (A-0524-BA) including:

– Declaration of knowledge of spoken French – (Francophone profile only); – Commitment to knowledge of French (Francization profile only); – Declaration of Democratic Values and Québec Values as expressed in the Charter of Human Rights

and Freedoms, duly signed and dated; – the completed and signed declaration of the principal applicant; – the Financial Self-Sufficiency Contract, duly completed and signed; – the completed and signed declaration of legal or de facto spouse, as applicable.

Special authorization

If this section does not apply to you, skip to the next section.Required document

2 • Special authorization from the Barreau du Québec or the Chambre des notaires du Québec, as applicable

The application form (Parts 1 and 2), declarations

and Financial Self-Sufficiency Contract must be completed,

printed, dated and signed.

Your legal or de facto spouse and dependent children 18 years

of age or older must also sign and date this declaration.

Both you and your spouse must sign the same declaration.

If the person representing you is not a member of the Barreau du Québec or the

Chambre des notaires, you must provide this document.

http://www.immigration-quebec.gouv.qc.ca/en/informations/document-requirements.html


Supporting documents

Identity and civil status Required document

3 • Pages of your valid passport and of each of your family members included in your application, showing the identity, date of issue and expiry of the passport and any changes to this information

4 • All work or study permits issued for you by Immigration, Refugees and Citizenship Canada (IRCC) and photocopies of your Quebec Certificate of Acceptance (CAQ) for the 36 months preceding your application

5 • Marriage certificate or deed

OR

• Judgment or certificate of divorce or marriage annulment

OR• Death certificate of your spouse

6 • At least two recent documents proving (for at least one year within 36 months prior to the date of application) your status showing your name and your legal or de facto spouse’s name.Eligible documents include:

– mortgage or rental agreement for a dwelling (lease); – joint bank statements; – common utility bills (electricity, gas, insurance, telephone or Internet service)

Dependent child(ren) included in your application Required document

7 • Birth certificate or full adoption certificate (which creates a new parent-child relationship and terminates the pre-existing parent-child relationship) for each child included in your application.

Child(ren) under 18 years of age accompanying you in the absence of the other parent Required document

8 • A declaration of parental consent made before a notary, magistrate, judge, court officer, employee of a government department or agency, or a diplomatic or consular representative of your country or territory of citizenship that contains all of the following mandatory items:

– the child’s first and last name; – the child’s date of birth; – the first and last name of the accompanying parent (you or your spouse); – the agreement of the non-accompanying parent expressly authorizing the permanent

immigration of his or her child to Québec; – the last name, first name and contact information of the non-accompanying parent,

in block letters; – signature of the non-accompanying parent; – the date of the declaration; – the full name of the notary, magistrate, judge, court officer, employee of a government

department or agency, or consular representative, in block letters; – the signature and professional seal of the notary, magistrate, judge, court officer,

employee of a government department, agency, consular or diplomatic representative

OR• A court order indicating that the accompanying parent has sole custody of the child.

OR• Death certificate of the parent

You must provide a document that proves your current

marital status.

If your legal or de facto spouse is included in the Application for selection, you must prove

that you have cohabited continuously for a period of at least 12 months (abroad

or in Québec, as applicable).

If your spouse is not included in your Application for selection,

you must still declare them in section 4 of part 1.

If your judgment indicates that the nonaccompanying parent is entitled to visitation or vacation

time with your child, you must provide a copy of a statement

of parental consent.


Accompanying dependent child(ren) age 22 or older Required document

9 • Medical certificate attesting to the physical or psychological disability of the dependent child as applicable

Documents to support your declaration of knowledge of spoken French Required document

10 • Attestation of results of a test or diploma acceptable to the Ministère de l’Immigration, de la Francization et de l’Intégration du Québec:

– Test d’évaluation du français adapté pour le Québec (French Evaluation Test adapted for Québec – TEFAQ);

– Test de connaissance du français pour le Québec (Tests of French knowledge for Québec – TCFQ); – Test d’évaluation du français (French evaluation – TEF); – Test d’évaluation du français pour le Canada (French Evaluation for Canada – TEF Canada); – Tests of French knowledge (TCF); – Diplôme d’études en langue française (Diploma of French Language Studies – DELF),

minimum requirement of 16/25; – Diplôme approfondi de langue française (Advanced French language diploma – DALF),

minimum requirement for DALF C1: 8/25 and DALF C2: 16/50.

For more information and to contact the centres that administer these tests and issue diplomas, visit https://www.quebec.ca/en/immigration/immigration-programs/quebec-experience-program/selection-conditions/knowledge-french

OR

• Final transcript of grades attesting to the successful completion of at least three years of full-time secondary or post-secondary education, completed in French (including a Master’s dissertation and doctoral thesis, as applicable).

AND

• When the national language of instruction is not exclusively French, you must present an attestation from the issuing educational institution.

Education Required document

11 • Diploma

OR

• Attestation of completion issued by the Registrar’s Office confirming that all program requirements have been met.

AND• Final transcript of grades

The result of a test or the French diploma are documents issued by assessment providers

or educational institutions that assess French

language proficiency.

These documents must present the results obtained in oral

comprehension and oral communication and indicate the

attainment of a level of proficiency equal to or higher

than Level 7 of the l’Échelle québécoise des niveaux de

compétence en français des personnes immigrantes adultes or its equivalent (e.g. the level

of proficiency in French for adults): B2 or higher on the

Common European Framework of Reference for Languages

The results must have been achieved less than

two years prior to the time of your application.

https://www.quebec.ca/en/immigration/immigration-programs/quebec-experience-program/selection-conditions/knowledge-french

https://www.quebec.ca/en/immigration/immigration-programs/quebec-experience-program/selection-conditions/knowledge-french


Job in the information technologies and visual effects sector Required document

12 • Attestation of employment

Each attestation of employment must be filed on company letterhead and must contain the following information:

– Title of the job held; – Duration and location of employment (start date and, as applicable, end date of employment); – the number of hours worked per week and the salary; – the position you are going to hold and its NOC code; – significant tasks and responsibilities; – Employer’s contact information (including phone number); – If applicable, the Numéro d’Entreprise au Québec (Québec Enterprise Number – NEQ); – the signature of your immediate supervisor or company personnel officer printed name

and date of signature.

Work experience

For each eligible job held full time, according to the National Occupational Classification (NOC) during the 60 months prior to submitting your application, you must provide:

Required document

13 • All work permits issued in the 60 months prior to your application

AND

14 • Attestation of employment

Each attestation of employment must be filed on company letterhead and must contain the following information:

– the job title and its associated NOC code; – Duration and location of employment (start and end dates of employment); – the number of hours worked per week and the salary; – the positions you held and the period during which you held each role (start and end dates); – significant tasks and responsibilities; – Employer’s contact information (including phone number); – the Numéro d’Entreprise au Québec (Québec Enterprise Number – NEQ); – the signature of your immediate supervisor or company personnel officer printed name

and date of signature.

AND

15 • At least three pay slips: – one from the beginning of the job; – one at the halfway point; – and the most recent pay slip issued by your employer prior to submitting your application.

Residency permit for your accompanying spouse Required document

16 • All valid residency permits issued by Immigration, Refugees and Citizenship Canada (IRCC) within the last 60 months, as applicable

Payment of the fees due

Only credit card payments are accepted in Arrima.

Employment on a 30-hour or more per week basis

is considered full time work experience.

The attestation of employment for your current job must

be dated within one month of the date you submit

your application.

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