Canada‑USA Application Form 1 (Fillable PDF)

The Canada‑USA Application Form 1 is the official document used for applying to cross‑border social‑security benefits under the United States‑Canada Social Security Agreement. This fillable PDF lets you provide personal details, social‑security numbers, and the specific benefits you are requesting.

What Is Application Form CDN‑USA 1?

This form, identified as ISP‑5054‑USA, is issued by Service Canada and is required when a U.S. resident applies for Canadian Old Age Security (OAS) or Canada Pension Plan (CPP) benefits, or when a Canadian resident applies for U.S. Social Security benefits. It captures essential identification data from both countries.

Key Sections of the Form

• Section 1 – Personal Information: Name, date of birth, and contact details.
• Section 2 – Social‑Security Numbers: U.S. SSN and Canadian SIN.
• Section 3 – Benefit Selection: Choose OAS, CPP, survivor benefits, or U.S. benefits.
• Section 4 – Signature & Date: Applicant’s declaration.

How to Complete the Form Online

Instead of downloading the PDF and opening a separate editor, simply click the "Fill out this form" button on this page. The Formize PDF Filler app will load in your browser, allowing you to type directly into each field, save progress, and export the completed form as a secure PDF.

Common Mistakes to Avoid

• Leaving the U.S. Social Security Number or Canadian SIN blank.
• Selecting the wrong benefit category.
• Forgetting to sign and date the form.
• Submitting a scanned copy with unreadable handwriting.

Download & Save Your Completed Form

After you finish, click Save to download the filled PDF to your device. Keep a copy for your records and submit the original to the appropriate agency (Service Canada or the U.S. Social Security Administration).