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INTER 83-172IE 2023-02-08
CHILD (15 OR YOUNGER) OR DEPENDENT ADULT APPLICATION
1.
Complete all applicable sections of the form. Do not forget to sign and date your application (section 7) to avoid delays.
Note: The gender designation selected on the form will be recorded as Male, Female or Another Gender on the Indian Register and
displayed on your Secure Certificate of Indian Status as M, F or X. The gender designation selected on the form does not need to
match the gender designation displayed on the documents submitted with your application or previously submitted to Indigenous
Services Canada.
2.
Provide the required documents for the CHILD or DEPENDENT ADULT:
• Submit the child’s or dependent adult’s PHOTO from your smartphone free of charge using the SCIS Photo App
OR submit 2 printed identical and unaltered passport-style quality photos (refer to the photo requirements).
• For a child, copy of the most recent LEGAL DOCUMENTS, such as a divorce order, separation agreement, custody or
guardianship order, granting custody or guardianship of the child to the applying parent or guardian, if applicable.
• For a dependent adult, copy of the ORDER OF GUARDIANSHIP.
• If the name of the child or dependent adult has changed, provide a LEGAL DOCUMENT that links their previous name
with their current name, such as a change-of-name certificate or an amended birth certificate with their current name.
If name-linking documents were provided previously to Indigenous Services Canada, you do not need to provide them again.
Provide an original name-linking document OR a copy of the name-linking document and a copy of a government-issued
identification document with their current name, such as a health card.
3.
Provide IDENTIFICATION that is valid and not expired for the applying PARENT or LEGAL GUARDIAN. Select ONE
of the following options:
Option 1 – Your Secure Certificate of Indian Status or your Certificate of Indian Status.
Option 2 – ONE piece of identification that includes your name, date of birth, photo and signature, from this list:
• Passport
• Driver's licence
• Canadian military identification (with or without a signature
or date of birth)
• Identification card issued by a province or territory
• Provincial, territorial or federal Correctional Services
identification (with or without a signature)
• Health card issued by a province or territory if it shows
your name, date of birth, photo and signature
• Canadian citizenship card issued prior to February 1, 2012
• Canadian permanent resident card with signature (issued
before February 4, 2012)
• U.S. permanent resident card
Option 3 – MULTIPLE pieces of identification that, when combined, include your name, date of birth, photo and signature, from
this list:
• Health card issued by a province or territory
• Government employee identification card
• Canadian permanent resident card without signature
(issued after February 4, 2012)
• U.S. passport card
• NEXUS or FAST card
• Firearms license
Option 4 – ONE piece of identification listed under option 3 and a Guarantor Declaration form (83-169E).
4.
If applicable, provide a copy of one or multiple LEGAL DOCUMENTS linking the parent’s or legal guardian’s previous
name with their current name, such as a change-of-name certificate, marriage certificate, divorce order or an amended birth
certificate. This is required only if the name of the applying parent or legal guardian on their identification documents is not the
same as on the custody or guardianship documents, or on documents previously submitted to Indigenous Services Canada,
for example, the birth certificate of the child or dependent adult submitted at the time of registration. If name-linking documents
were provided previously, you do not need to provide them again.
5.
Provide a GUARANTOR DECLARATION form (83-169E) if submitting your application by mail (refer to the
instructions on page 1) or if required with the parent’s or legal guardian’s identification documents.
Note: If you are applying in person, bring your original identification documents.
If you are applying by mail, you must submit a Guarantor Declaration form (83-169E) and copies of the front
and back of your identification documents, each copy signed and dated by your guarantor.