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H Day Adoptive Yes From Y M Month To M Destination (Country) Day No Y If no, go to Section 10. If yes, give details of the time the child spent away from Canada. Y FROM M D Y TO M D DESTINATION What country did the child go to? REASON Why did the child go to this country? # of days absent days days days days days days days days days days days Use another piece of paper if you need more space. CIT 0003 (02-2013) E TOTAL days PAGE 3 OF 5 10 PROHIBITIONS UNDER THE CITI.

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