If this return is for a deceased person, enter their information in Step 1 and see the Federal Income Tax and Benefit Guide.
First name
Social insurance number (SIN)
Last name
Date of birth (Year Month Day)
Mailing address: Apt No – Street No Street name
Your language of correspondence: EnglishFrançais
PO Box RR
Is this return for a deceased person? . . . Yes
City Prov./Terr. Postal code
Email address
Employment income (box 14 of all T4 slips)10100
Tax-exempt income for emergency services volunteers10105
Commissions included on line 10100 (box 42 of all T4 slips)10120
Wage loss replacement contributions10130
Other employment income10400
Old age security (OAS) pension (box 18 of the T4A(OAS) slip)11300
CPP or QPP benefits (box 20 of the T4A(P) slip)11400
Other pensions and superannuation11500
Elected split-pension amount (attach Form T1032)11600
Employment insurance (EI) and other benefits (box 14 of the T4E slip)11900
Taxable amount of dividends from taxable Canadian corporations12000
Interest and other investment income (use Federal Worksheet)12100
Net partnership income: limited or non-active partners only12200
Rental income (see Form T776) — Gross 12599 . . . . Net12600
Taxable capital gains (complete Schedule 3)12700
Support payments received — Total 12799 . . . . Taxable amount12800
RRSP income (from all T4RSP slips)12900
Other income — Specify:13000
Taxable scholarships, fellowships, bursaries, and artists' project grants13010
Add lines 10100, 10400 to 14300. This is your total income.15000