Schedule A – Background/Declaration (IMM 5669)
Who must fill out this application form?
This form must be completed by:
you, the principal applicant;
your spouse or common-law partner (whether accompanying you to Canada or not), and
your dependent children aged 18 years or older (whether accompanying you to Canada or not).
For refugee claimants in Canada: Only family members included in your application for refugee protection who are with you in Canada must complete this form.
Question 1
Indicate your full
family name (surname or last name) as it appears on your passport, travel or identity document.
Indicate all of your
given name(s) (first, second or more) as they appear on your passport, travel or identity document. Do not use initials.
Question 2
Indicate your name in your native language or script
(if applicable).
For example: Arabic, Cyrillic, Chinese, Farsi, Korean, Japanese characters or Chinese commercial/telegraphic code.
Only when it's applicable.
http://www.cic.gc.ca/english/information/applications/guides/EP7TOC.asp