Assessment Form For Citizenship & Residence by Investment Amir Ismail & Associates Global Citizenship & Immigration Advisers - Member of ICCRC & CAPIC Canada Basic Information: Full Name * First Name Last Name Address * Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia South Sudan Spain Sri Lanka Sudan Suriname Svalbard eSwatini Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Phone Number * - Area Code Phone Number Cell Phone * - Prefix Phone Number E-mail * Your Age * Choice of Residence or Direct Citizenship Program * Canada Residency - Entrepreneur (with net worth starting at C$600,000 and investment starting at C$200,000) Canada Residency - Investor (with net worth of C$2.0 Million and investment of C$300,000 - Non Refundable or C$1.0 Million - Refundable after 5 years without any interest) Bulgaria Residency (with investment of EUR511,292) Bulgaria Direct Citizenship (with investment of EUR1,024,000) USA Residency (with investment of US$500,000) Cyprus Residency (with investment of EUR300,000) Cyprus Direct Citizenship (With Investment of EUR 2 Million) Malta Residence Program (With investment of EUR 600,000) Malta Direct Citizenship (With investment of EUR 900,000) UK Residency - Entrepreneur (With investment of GBP 200,000) UK Residency - Investor (With Investment of GBP 2 Million) Portugal Residency (With Investment of EUR 250,000 to 500,000) Antigua and Barbuda Direct Citizenship (With investment starting at US$100,000 - Limited time) St. Kitts and Nevis (With Investment Starting at US$150,000 - Limited time) Grenada Direct Citizenship (With investment starting at US$150,000) St. Lucia Direct Citizenship (With investment starting at US$100,000) Dominica Direct Citizenship (With investment starting at US$100,000) Greece Residence (With investment starting at EUR250,000) Far East Residence (Hong Kong, Thailand, Malaysia, Singapore) Marital Status * Single Married Divorced Separated Widowed Education: Educational Qualification * Master Degree Bachelors Degree Diploma High School Secondary School Business/Senior Management Experience: Name of Business/Employer * Business/Employer Address * Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia South Sudan Spain Sri Lanka Sudan Suriname Svalbard eSwatini Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Type of Business/Company * Year Established * Position in Company * Sole Proprietor Director Partner % of ownership in business (put 0 if you are an employee) * # of employees supervised * INDICATE YOUR NET WORTH IN US DOLLARS Total value of all your assets such as real estate properties, cash, savings etc) A: Assets: 1. Cash (US$) * 2.Value of all properties owned by you and your spouse (if applicable) (US$) * 3. Publically traded stocks and other passive investments (US$) * 4. Market Value of Business (US$) * 5. Pensions, Provident Funds; Other Assets (US$) - Also give description. * Total Assets (Add Cash, Properties and all other assets indicated in 1,2,3,4 and 5 above) * B: Liabilities: 1. Mortgages * 2. Personal /other Loans or Debts * Total Liabilities : 1+2 * Contribution Amount Indicate how much you are willing to contribute for a family of four, in US$ CONTRIBUTION TYPE Indicate the type of contrubution you would like to make Donation Government bonds Bank deposit Real estate Project FINANCING Indicate if you would like to finance the required contribution Yes No Speed Indicate how important it is the time to obtain citizenship Very important Somewhat important Not important at all RELOCATION Indicate if relocating to fulfill citizenship requirements is an option for you Yes No MOBILITY Indicate which countries and/or regions you would like to travel to visa-free Canada USA Europe (Schengen zone) SIMPLICITY Indicate how important it is a simple procedure. Very important Somewhat important Not important at all QUALITY OF LIFE Indicate how important it is the quality of life. Very Important Somewhat Important Not Important at all Family Members: Spouse's Education * Not Applicable Masters Degree Bachelors Degree Diploma High School Secondary School Spouse's Profession * Not Applicable Housewife Restaurant and Food Service Managers Primary Production Managers (Except Agriculture) Advertising account executive Advertising consultant Advertising specialist Adviser, corporate development planning Analyst, business management Analyst, business methods Business consultant Business management analyst Business management consultant Business methods analyst Certified management consultant Consultant, advertising Consultant, business Consultant, management Consultant, organizational analysis Corporate development planning adviser Corporate planner ISO consultant Management analyst Management consultant Marketing specialist – advertising Operations management senior consultant Organizational analyst Organizer, advertising campaign Product manager – marketing Promotion representative Promotion specialist Promotion strategies consultant Quality auditor, industrial standards Senior consultant, operations Senior marketing consultant Insurance Adjusters and Claims Examiners Biologists and Related Scientists Architects Specialist Physicians General Practitioners and Family Physicians Dentists Pharmacists Physiotherapists Registered Nurses Medical Radiation Technologists Dental Hygienists & Dental Therapists Licensed Practical Nurses Psychologists Social Workers Chefs Cooks Contractors and Supervisors, Carpentry Trades Contractors and Supervisors, Mechanic Trades Electricians (Except Industrial & Power System) Industrial Electricians Plumbers Welders & Related Machine Operators Heavy-Duty Equipment Mechanics Crane Operators Drillers & Blasters - Surface Mining, Quarrying & Construction Supervisors, Oil and Gas Drilling and Service His her occupation is not listed If spouses's profession is not listed, indicate his/her profession here # of years of experience of spouse * Less than 1 year 1 year 2 years 3 years 4 years or more Upload your Spouse's CV (doc, pdf or txt files) A CV will help us make an accurate assessment Relationship in Canada: Do you have relatives in Canada * Yes No Relationship with Canadian relative * Not Applicable Brother Sister Uncle Aunt Nephew Niece Grandfather Grandmother Where in Canada your relatives are located * How did you hear about us * Seminar Internet Search Advertisement Facebook - http://www.facebook.com/canadaimmigration Personal Reference Website of Immigration Consultants of Canada Regulator Council (ICCRC) Twitter - @Canadaimmigrate Telephone Youtube: aiaconsulting Save Submit Form Should be Empty:
