Canada Revenue Agency
Agence du revenu du Canada
T1 GENERALProtected B when completed
Income Tax and Benefit Return
If this return is for a deceased person, enter their information in Step 1 and see the Federal Income Tax and Benefit Guide.
Step 1 – Identification and other information
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
Marital status on December 31:
1 Married2 Living common-law3 Widowed4 Divorced5 Separated6 Single
Information about your residence
Enter your province or territory of residence on December 31:
If you became or ceased to be a resident of Canada for income tax purposes during the year, enter the date of:    entry    or departure
Step 2 – Total income
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
Form1040-NR
Department of the Treasury—Internal Revenue Service
U.S. Nonresident Alien Income Tax Return
OMB No. 1545-0074
IRS Use Only—Do not write or staple in this space.
For the year Jan. 1–Dec. 31, or other tax year beginning , ending   See separate instructions.
Filing StatusCheck only one box.
SingleMarried filing separately (MFS)Qualifying surviving spouse (QSS)
EstateTrust
If you checked the QSS box, enter the child's name if the qualifying person is a child but not your dependent:
Your first name and middle initial
Last name
Identifying number (see instructions)
Home address (number, street, and apt. no., or rural route). If you have a P.O. box, see instructions.
Apt. no.
Check if:
☐ You were a dual-status alien
City, town, or post office. If you have a foreign address, also complete spaces below.
State
ZIP code
Foreign country name
Foreign province/state/county
Foreign postal code
Digital Assets
At any time during the tax year, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell, exchange, or otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.)  YesNo
Dependents(see instructions)
(1) First name      Last name(2) Identifying number(3) Relationship to you(4) Child tax creditCredit for other dependents
Income Effectively Connected With U.S. Trade or BusinessAttach Form(s) W-2 here. Also attach Forms 1042-S, SSA-1042S, RRB-1042S, and 1099-R if tax was withheld.
1aTotal amount from Form(s) W-2, box 1 (see instructions)1a
bHousehold employee wages not reported on Form(s) W-21b
cTip income not reported on line 1a (see instructions)1c
dMedicaid waiver payments not reported on Form(s) W-21d
eTaxable dependent care benefits from Form 2441, line 261e
fEmployer-provided adoption benefits from Form 8839, line 291f
gWages from Form 8919, line 61g
hOther earned income (see instructions)1h
kTotal income exempt by a treaty from Schedule OI (Form 1040-NR)1k
zAdd lines 1a through 1h1z
2aTax-exempt interest . . . . . . . b Taxable interest2b
3aQualified dividends . . . . . . . b Ordinary dividends3b
4aIRA distributions . . . . . . . . b Taxable amount4b
5aPensions and annuities . . . . . b Taxable amount5b
6Reserved for future use6
7Capital gain or (loss). Attach Schedule D (Form 1040)7
8Additional income from Schedule 1 (Form 1040), line 108
9Add lines 1z, 2b, 3b, 4b, 5b, 7, and 8. This is your total effectively connected income9
10Adjustments to income from Schedule 1 (Form 1040), line 2610
11Subtract line 10 from line 9. This is your adjusted gross income11
Form1040
Department of the Treasury—Internal Revenue Service
U.S. Individual Income Tax Return
OMB No. 1545-0074
IRS Use Only—Do not write or staple in this space.
For the year Jan. 1–Dec. 31, or other tax year beginning , ending    See separate instructions.
Filing StatusCheck only one box.
SingleMarried filing jointly (even if only one had income)
Married filing separately (MFS)Head of household (HOH)Qualifying surviving spouse (QSS)
If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QSS box, enter the child's name if the qualifying person is a child but not your dependent:
Your first name and middle initial
Last name
Your social security number
If joint return, spouse's first name and middle initial
Last name
Spouse's social security number
Home address (number and street). If you have a P.O. box, see instructions.
Apt. no.
Presidential Election Campaign
Check here if you, or your spouse if filing jointly, want $3 to go to this fund.
City, town, or post office. If you have a foreign address, also complete spaces below.
State
ZIP code
Foreign country name
Foreign province/state/county
Foreign postal code
Digital Assets
At any time during the tax year, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell, exchange, or otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.)  YesNo
Standard Deduction
Someone can claim: You as a dependentYour spouse as a dependent
Spouse itemizes on a separate return or you were a dual-status alien
Age/Blindness
You: Were born before January 2, 1961Are blind Spouse: Was born before January 2, 1961Is blind
Dependents(see instructions):
If more than four dependents, see instructions and check here
(1) First name      Last name(2) Social security number(3) Relationship to you(4) Child tax creditCredit for other dependents
IncomeAttach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld.

If you did not get a Form W-2, see instructions.
1aTotal amount from Form(s) W-2, box 1 (see instructions)1a
bHousehold employee wages not reported on Form(s) W-21b
cTip income not reported on line 1a (see instructions)1c
dMedicaid waiver payments not reported on Form(s) W-21d
eTaxable dependent care benefits from Form 2441, line 261e
fEmployer-provided adoption benefits from Form 8839, line 291f
gWages from Form 8919, line 61g
hOther earned income (see instructions)1h
iNontaxable combat pay election (see instructions)
zAdd lines 1a through 1h1z
2aTax-exempt interest . . . . . . . . b Taxable interest2b
3aQualified dividends . . . . . . . . b Ordinary dividends3b
4aIRA distributions . . . . . . . . . b Taxable amount4b
5aPensions and annuities . . . . . . b Taxable amount5b
6aSocial security benefits . . . . . b Taxable amount6b
7Capital gain or (loss). Attach Schedule D if required7
8Additional income from Schedule 1, line 108
9Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income9
10Adjustments to income from Schedule 1, line 2610
11Subtract line 10 from line 9. This is your adjusted gross income11
M   GT3,482.50
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Form 1040 / 1040-NR
U.S. Tax Returns
Resident, non-resident, and dual-status U.S. returns for Canadians with U.S. filing obligations.
Who this is for
Canadian residents who are U.S. citizens, green card holders, or otherwise required to file a U.S. return.
What's included
Form 1040 or 1040-NR preparation
and e-filing
Foreign tax credit and treaty position
claims to avoid double tax
Coordination with your Canadian T1
so both returns agree
Review of prior filings for missed
credits or elections