Have you, your spouse/partner or your family members listed above, ever:
1. been convicted of a crime or offence in Canada for which a pardon has not been granted under the Criminal Records Act of Canada?
2. been convicted of, or are you currently charged with, on trial for, or party to a crime or offence, or subject of any criminal proceedings in any other country or territory?
3. made previous claims for refugee protection in Canada or at a Canadian visa office abroad, in any other country(ies) or territory(ies), or with the United Nations High Commissioner for Refugees (UNHCR)?
4. been refused refugee status, an immigrant or permanent resident visa (including a Certificat de selection du Quebec (CSQ) or application to the Provincial Nominee Program) or visitor or temporary resident visa, to Canada or any other country or territory?
5. been refused admission to, or ordered to leave, Canada or any other country or territory?
6. been involved in an act of genocide, a war crime or in the commission of a crime against humanity?
7. used, planned or advocated the use of armed struggle or violence to reach political, religions or social objectives?
8. been associated with a group that used, uses, advocated or advocates the use of armed struggle or violence to reach political, religious or social objectives?
9. been member of an organization that is or was engaged in an activity that is part of a pattern of criminal activity?
10. been detained, incarcerated or put in jail?
11. had any serious disease or physical or mental disorder?