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Form IR-1 (Rule 5)

Court File No.

FEDERAL COURT

Between:

(Insert, as applicable, the full name of party, the Minister of Citizenship


and Immigration or each Minister responsible for the administration of
the Immigration and Refugee Protection Act in respect of the matter
for which leave is sought.)

Applicant(s)

and

(Insert, as applicable, the full name of party, the Minister of Citizenship


and Immigration or each Minister responsible for the administration of
the Immigration and Refugee Protection Act in respect of the matter
for which leave is sought.)

Respondent(s)

Application for Leave and for Judicial


Review

TO THE RESPONDENT(S)

AN APPLICATION FOR LEAVE TO COMMENCE AN APPLICATION FOR


JUDICIAL REVIEW has been commenced by the applicant(s) under

(Select the provision under which this application is made.)

 [ ] SUBSECTION 22.1(1) OF THE CITIZENSHIP ACT; or


 [ ] SUBSECTION 72(1) OF THE IMMIGRATION AND REFUGEE
PROTECTION ACT.

UNLESS A JUDGE OTHERWISE DIRECTS, THIS APPLICATION FOR


LEAVE will be disposed of without personal appearance by the parties,
in accordance with paragraph 22.1(2)(c) of the Citizenship Act or
paragraph 72(2)(d) of the Immigration and Refugee Protection Act, as
the case may be.

IF YOU WISH TO OPPOSE THIS APPLICATION FOR LEAVE, you or a


solicitor authorized to practise in Canada and acting for you must
prepare a Notice of Appearance in Form IR-2 prescribed by the Federal
Courts Citizenship, Immigration and Refugee Protection Rules, serve it
on the tribunal and each applicant’s solicitor or, in the case where an
applicant does not have a solicitor, serve it on the applicant, and file it,
with proof after service, in the Registry, within 10 days after the day
on which this application for leave is served.

IF YOU FAIL TO DO SO, the Court may dispose of this application for
leave and, if the leave is granted, of the subsequent application for
judicial review without further notice to you.

 Note:

Copies of the relevant Rules of Court, information on the local


office of the Court and other necessary information may be
obtained from any local office of the Federal Court or the
Registry in Ottawa (telephone: 613-992-4238).

The applicant seeks leave of the Court to commence an application for


judicial review of:

(Set out the date and details of the matter — the decision or order
made, measure taken or question raised — in respect of which a
judicial review is sought and the date on which the applicant was
notified or otherwise became aware of the matter.)
(Set out the name, address and telephone number of the tribunal and,
if the tribunal was composed of more than one person, the name of
each person who was on the tribunal.)

(Set out the tribunal’s file number(s), if applicable.)

(Add the following paragraph, if applicable.)

[The applicant also applies to the Court for an extension of time to file
and serve the application under paragraph 22.1(2)(b) of the Citizenship
Act or under paragraph 72(2)(c) of the Immigration and Refugee
Protection Act, as the case may be, for the following special reasons:

(Set out the special reasons for the request for the extension of time. )]

The application for leave was prepared by:

(As applicable, set out the name of the solicitor or party signed below
or the name, address and telephone number of any other person who,
for a fee or other consideration, prepared the application for leave. )

The applicant’s electronic address for the service of documents is:


(Set out the electronic address for the service of documents specified
in Form 141A of the Federal Court Rules, if any.)

If the application for leave is granted, the applicant seeks the


following relief by way of a judicial review:

(Set out the precise relief sought should leave be granted, including
any statutory provision or rule relied on.)

If the application for leave is granted, the application for judicial


review is to be based on the following grounds:

(Set out the grounds to be argued, including a reference to any


statutory provision or rule to be relied on.)

The applicant (has or has not) received written reasons from the
tribunal.
If the application for leave is granted, the applicant proposes that the
application for judicial review be heard at (place), in the (English
and/or French) language.

(Signature of solicitor or applicant)


(Name, address and telephone number of solicitor or applicant)

To: (Name(s) and address(es) of respondent(s))

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