Personal Income Tax Return Form




      SingleMarriedWidowedDivorcedSeparated







      CNILRRSPLossesCGE

      Self EmployedSalatiedCommissionedDid Not WorkTaxpayer









    Income Sources

    Status

    Comments

    T3

      YesNON/A

    T4/ T4A

      YesNON/A

    T4RSP

      YesNON/A

    T4U ( unemployment insurance )

      YesNON/A

    T5 ( interest income, dividends, CSB, cap gain )

      YesNON/A

    Taxable Capital Gain on sale of ?

      YesNON/A

    Commissions

      YesNON/A

    Other employment income ?

      YesNON/A

    Workers Compensation payments or Social Assistance

    Old Age Security T4A(OAS)

      YesNON/A

    Canada Pension Plan benefits T4A(P)

      YesNON/A

    Other Pension ?

      YesNON/A

    Alimony income

      YesNON/A

    Rental income and expence - please attach

      YesNON/A

    Deductions / Expenses / Credits

    Status

    Comments

    RRSP contribution ? attached notice of assessment

      YesNON/A

    Union or professional dues

      YesNON/A

    Child care expenses: amt. pd. child

      YesNON/A

    Carrying charges (interest paid/safety dep. box.)

      YesNON/A

    Tuition fees/Education amount

      YesNON/A

    Medical receipts attached

      YesNON/A

    Disability credit ( )

      YesNON/A

    Transferable items (Age/Disability/Tuition/Pension)

      YesNON/A

    Donation/Political contributions

      YesNON/A

    Alimony payments

      YesNON/A

    Moving expenses

      YesNON/A

    Employment expenses - NEED T2200

      YesNON/A

    Business investment losses

      YesNON/A

    Losses to apply

      YesNON/A

    Capital gains deducation

      YesNON/A

    Other deducations/expenses/credits?

      YesNON/A

    DEPENDANTS

     

    Name

    DOB

    SON/DTR

    Net Income

    Infirm ?

    1

    2

    3

    4

    5

    6

    Rental Information




    Expenses











    NET RENTAL INCOME




    Portion reported by:

     

     

    SIN

     

    1

    2

    3

    4