Income Tax And Benefit Return

Protected B when completed

T1 GENERAL 2012
Income Tax and Benefit Return
Complete all the sections that apply to you. For more information, see the guide.

8
Information about you

Identification

Enter your social insurance number (SIN):
Year

Print your name and address below.

Month

Day

Enter your date of birth:
English

Your language of correspondence:
Votre langue de correspondance :

First name and initial

Français

Marital status

Last name

Tick the box that applies to your marital status on December 31, 2012:
Mailing address: Apt No – Street No Street name
PO Box

Prov./Terr.

Married
Divorced

2
5

Living common-law
Separated

3
6

Widowed
Single

RR

City

1
4

Postal code

Information about your spouse or common-law partner (if you ticked box 1 or 2 above)
Enter his or her SIN:

Information about your residence

Enter his or her first name:

Enter your province or territory of residence on December 31, 2012:

Enter his or her net income for 2012 to claim certain credits:

Enter the province or territory where you currently reside if it is not the same as your mailing address above:

Enter the amount of universal child care benefit (UCCB) from line 117 of his or her return:

If you were self-employed in 2012, enter the province or territory of self-employment: Enter the amount of UCCB repayment from line 213 of his or her return:
Tick this box if he or she was self-employed in 2012:

If you became or ceased to be a resident of Canada for income tax purposes in 2012, enter the date of:
Month Day
Month Day entry or

Person deceased in 2012
If this return is for a deceased person, enter the date of death:

departure

1

Year

Month

Day

Do not use this area

Elections Canada (see the Elections Canada page in the tax guide for details or visit www.elections.ca)
A) Are you a Canadian citizen? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
Answer the following question only if you are a Canadian citizen.
B) As a Canadian citizen, do you authorize the Canada Revenue Agency to give your name, address, date of birth, and citizenship to Elections Canada to update the National Register of Electors? . . . . . . . Yes

1

No

2

1

No

2

Your authorization is valid until you file your next return. Your information will only be used for purposes permitted under the Canada
Elections Act, which include sharing the information with provincial/territorial election agencies, members of Parliament, and registered political parties, as well as candidates at election time.

Goods and services tax/harmonized sales tax (GST/HST) credit application
See the guide for details.
Are you applying for the GST/HST credit?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes

Do not use this area
5000-R

172

171

1

No

2

Protected B when completed

The guide contains valuable information to help you complete your return.
When you come to a line on the return that applies to you, go to the line number in the guide for more information.

Please answer the following question:
Did you own or hold foreign property at any time in 2012 with a total cost of more than
CAN$100,000? see "Foreign income" section in the guide for more information . . . . . . 266 Yes

1

No

2

If yes, complete Form T1135 and attach it to your return.
If you had dealings with a non-resident trust or corporation in 2012, see "Foreign income" in the guide.

As a resident of Canada, you have to report your income from all sources both inside and outside Canada.

Total income
Employment income (box 14 of all T4 slips)
Commissions included on line 101 (box 42 of all T4 slips)
Other employment income
Old age

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