ELECTRONIC TAX RETURN - INFORMATION FORM ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ (DRAFT - February 11, 1992) Designed by: Gauranga Gupta, B.Comm.,CMA G. Gupta & Associates 123 Neddie Drive Scarborough, Ontario M1T 3R9 Phone: (416) 412-1376 Fax: (416) 412-1375 The forms that follow have been designed for use by tax preparers using electronic data transmission through a BBS or by direct connection between the modems of the two parties involved. The forms, once completed by the client, can be used to enter data on to a tax preparation software and the completed returns can then be transmitted in the same manner back to the client. Alternatively the completed forms can be faxed to the tax preparer along with all his/her information slips. In such a situation, the sections summarizing information slips will of course be unnecessary. Completed returns can then be returned by fax or my mail. Returns sent by fax can be photocopied on to blue paper for submission to Revenue Canada. In either case, the primary benefit from having returns prepared in this manner is that they can be prepared by a professional tax preparer without the client having to step out of his home. *********CAUTIONS & DISCLAIMER********** This version is currently under development and is incomplete in certain sections. Tax preparers are free to use the forms as designed to date at their own risk. The author provides no guarantees on the accuracy or completeness of these forms and will in no way accept liability for any errors and consequential damages arising out of the use of these forms. *************************************** INSTRUCTIONS ^^^^^^^^^^^^ File Information: 1. The file is in ASCII format and can be edited using most word precessing software or text editors. 2. If you are using a wordprocessor, set the left and right margins to .5" each, and the font size to 10 CPI, before loading this file. 3. Change to insert mode to before entering data, overtyping on the spaces underlined. 4. Save the file in ASCII format, compress it using PKZIP and transmit to the taxpreparer. If uploading to a BBS, encript the compressed file to ensure confidentiality. Use filenames for the ASCII and ZIP files that identify the taxpayer, e.g. TXGUPTA.TXT and TXGUPTA.ZIP. Command for compressing the file: PKZIP -a TXGUPTA.ZIP TXGUPTA.TXT. Form Information: 1. Complete one form for each individual taxpayer. 2. Sections of the form that are not used should be deleted prior to transmittal. 3. Complete the General Information section first and then, using the T1 form supplied by Revenue Canada as a guide, fill in the information that is relevant to your return, as follows: Go through the sections headed GENERAL INFORMATION, DEDUCTIONS FROM INCOME and PERSONAL DEDUCTIONS, and enter information either in those sections directly or, if indicated, on the appropriate schedule or form. To locate the forms, look through the list of forms. TIP: Print out Pages 2 to 4 of this file and work with the forms and schedules on the PC without printing them out. 4. Ensure that all the necessary forms have been completed, verify the information and save the file in ASCII format for transmission. GENERAL INFORMATION ^^^^^^^^^^^^^^^^^^^ Name _________________________ Your S.I.N.____________________ Address _________________________ Spouse's S.I.N.____________________ _________________________ Marital Status ____________________ City _________________________ Spouse's Name ____________________ Prov/Postal Code ________________ Date of birth ____________________ Phone Numbers: Home_______________ Office ____________________ Province of residence ____________ Province of business ______________ (Both of above as on December 31, 1991) Type of Work _____________________ Employer __________________________ Name & S.I.N. of "Other Supporting Person" ________________________________ CARRY FORWARDS from 1990 Capital gains deduction to date: _________ Cumulative net investment loss: Total investment expenses claimed in previous years _________ Total investment income claimed in previous years _________ Office in home expense carry forward _________ RRSP contributions to own plan in first 60 days of 1991 and not deducted on 1990 return _________ RRSP contributions to spousal plan in first 60 days of 1991 and not deducted on 1990 return _________ Unused charitable donations at the start of 1991 _________ Moving expenses incurred in 1990 but not deducted _________ Accumulated averaging amount at the end of 1989 _________ Accumulated averaging amount withdrawal in 1990 _________ Alternative minimum tax carried over from 1990 _________ Additional Information that will help the tax preparer in completing your return:____________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ INCOME ^^^^^^ (Mark lines on which you have information with an "X" as on line 1) 1. Employment Income X Complete T4 Section 2. Other Employment Income _ From slip or Amount $__________ 3. Old Age Pension _ Complete T4A(OAS) Section 4. Canada Pension Plan _ Complete T4A(P) Section 5. Other Pensions _ Complete T4A Section 6. Family Allowances _ Complete TFA1 Section 7. Interest & Dividends _ Complete T5 Section 8. Partnership Income _ Amount $__________ 9. Rental Income _ Gross________ Net_________ 10. Capital Gains _ From slip or complete form 1 11. Alimony/Separation Allce _ Amount $__________ 12. RRSP Income _ Complete T4RSP 13. Other Income _ Amount $__________ 14. Business Income _ Gross________ Net_________ 15. Professional Income _ Gross________ Net_________ 16. Commission Income _ Gross________ Net_________ DEDUCTIONS FROM INCOME ^^^^^^^^^^^^^^^^^^^^^^ 1. Pension contributions _ From slip or Amount $__________ 2. RRSP contributions _ Complete form 2 3. Union or Prof. Dues _ From slip or Amount $__________ 4. Child Care Expenses _ Complete form 3 5. Alimony/Separation Allce _ Amount $__________ 6. Carrying Charges _ Complete form 4 7. Other deductions _ Complete form 5 PERSONAL DEDUCTIONS ^^^^^^^^^^^^^^^^^^^ 1. Supported spouse whose net income was nil (Y/N) ____ 2. Details of children with no earnings Name Relation Date of birth Infirmity _________________ ________ _____________ ____________ _________________ ________ _____________ ____________ _________________ ________ _____________ ____________ _________________ ________ _____________ ____________ 3. Additional personal amounts- Complete form 6 4. Tuition fees - Amount $______or Complete form 7 5. Medical Expenses - Complete form 8 6. Charitable Donations - Complete form 9 7. Gifts to Canada/Province - Complete form 9 INFORMATION SLIPS ^^^^^^^^^^^^^^^^^ List of Forms T3 - Statement of Trust & Other Income T4 - Statement of Remuneration Paid T4A - Statement of Pension, Retirement, Annuity & Other Income T4A(OAS) - Statement of Old Age Security T4A(P) - Statement of Canada Pension Plan Benefits T4RIF - Statement of Income Out of a Registered Retirement Income Fund T4RSP - Statement of Registered Retirement Savings Plan Income T4U - Statement of Unemployment Insurance Benefits Paid TFA1 - Statement of Family Allowances T5 - Statement of Investment Income Annual Accrual Form for Compound Interest Canada Savings Bonds T600 - Coupon Payments on Bonds T778 - Calculation of Child Care Expenses Deduction T1 GSTC - Goods & Services Tax Credit Application Form Form 1 - Self Employment Report Form 2 - Summary of Capital Dispositions in 1991 Form 3 - RRSP Contributions Form 4 - Carrying Charges Form 5 - Other Deductions Form 6 - Additional Personal Amounts Form 7 - Tuition Fees Form 8 - Medical Expenses Form 9 - Charitable Donations Form 10 - Federal Supplements, Social Assistance & Workers' Compensation Form 11 - Ontario Tax Credits *************************************************************************** T3 - Statement of Trust & Other Income ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Payer _____________ ____________ ____________ _____________ ____________ ____________ Capital gains Box 21 _________ _________ _________ Pension benefits Box 22 _________ _________ _________ Foreign business income Box 24 _________ _________ _________ Foreign non-business income Box 25 _________ _________ _________ Other income Box 26 _________ _________ _________ Cap Gains eligible for ded Box 30 _________ _________ _________ Eligible pension income Box 31 _________ _________ _________ Taxable dividends Box 32 _________ _________ _________ Foreign business tax paid Box 33 _________ _________ _________ Foreign non-bus tax paid Box 34 _________ _________ _________ Death benefits Box 35 _________ _________ _________ Insur. seg. fund losses Box 37 _________ _________ _________ Part XII.2 tax credit Box 38 _________ _________ _________ Dividend tax Credit Box 39 _________ _________ _________ Invest TC - Investment Box 40 _________ _________ _________ - Tax credit Box 41 _________ _________ _________ Other TC - Type Box 42 _________ _________ _________ - Amount Box 42 _________ _________ _________ Additional Information ^^^^^^^^^^^^^^^^^^^^^^ Interest or Rental (Y/N) Box 26 _________ _________ _________ Investment Earnings (Y/N) Box 34 _________ _________ _________ *************************************************************************** T4 - Statement of Remuneration Paid ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Payer _____________ ____________ ____________ _____________ ____________ ____________ Total earnings Box 14 _________ _________ _________ Canada pension plan/QPP Box 16 _________ _________ _________ Employee's UI Premium Box 18 _________ _________ _________ RPP Contributions Box 20 _________ _________ _________ Income tax deducted Box 22 _________ _________ _________ UI Insurable earnings Box 24 _________ _________ _________ CPP Pensionable earning Box 26 _________ _________ _________ Union Dues Box 44 _________ _________ _________ Charitable Donations Box 46 _________ _________ _________ Payments to DPSP Box 48 _________ _________ _________ Pension adjustment Box 52 _________ _________ _________ Other EMPLOYMENT income not reported on T4/T4A slips: Tips and gratuities _________ _________ _________ Amounts already included in Box 14: Housing,Board,Lodging Box 30 _________ _________ _________ Travel in Presr. Area Box 32 _________ _________ _________ Int.Free/Low Int.Loans Box 34 _________ _________ _________ Stock Option Benefits Box 36 _________ _________ _________ Other Taxable Benefits Box 40 _________ _________ _________ Employment Commissions Box 42 _________ _________ _________ Pay periods re:UIC 52 weeks (Y/N) __ __ __ Footnotes: T4 #1_______________________________________________________________________ T4 #2_______________________________________________________________________ T4 #3_______________________________________________________________________ *************************************************************************** T4A - Statement of Pension, Retirement, Annuity & Other Income ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Payer _____________ ____________ ____________ _____________ ____________ ____________ Pension/Superannuation Box 16 _________ _________ _________ Lump sum payments Box 18 _________ _________ _________ Self-employed commissions Box 20 _________ _________ _________ Income tax deducted Box 22 _________ _________ _________ Annuities Box 24 _________ _________ _________ Retiring allowance Box 26 _________ _________ _________ Other income Box 28 _________ _________ _________ Patronage Allocations Box 30 _________ _________ _________ RPP Contr.- past service Box 32 _________ _________ _________ Pension adjustment Box 34 _________ _________ _________ Footnotes Code Box 38 ____ ____ ____ Was amount received as a result of the death of a spouse? (Y/N) __ __ __ Additional Information: ^^^^^^^^^^^^^^^^^^^^^^ Box 16 - DPSP ? (Y/N) __ Box 18 - DPSP ? (Y/N) __ Box 24 - General Annuity (Y/N) __ Box 26 - Eligible (Y/N) __ Box 28 - Death Benefit ? (Y/N) __ Box 28 - Termination Pmt (Y/N) __ Footnotes(see Box 38) T4A #1 ___________________________________________________________________ T4A #2 ___________________________________________________________________ T4A #3 ___________________________________________________________________ *************************************************************************** T4A(OAS) - Statement of Old Age Security ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Net old age security Box 18 _________ Net federal supplements Box 21 _________ Income tax deducted Box 22 _________ *************************************************************************** T4A(P) - Statement of Canada Pension Plan Benefits ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Effective date Box 13 _______________ Retirement benefit Box 14 _________ Survivor benefit Box 15 _________ Disability benefit Box 16 _________ Child benefit Box 17 _________ Death benefit Box 18 _________ Taxable CPP benefits Box 20 _________ Income tax deducted Box 22 _________ Net old age security Box 24 _________ *************************************************************************** T4RIF - Statement of Income Out of a Registered Retirement Income Fund ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Amounts taxable Box 16 _________ _________ _________ Deemed Receipt - Deceased Box 18 _________ _________ _________ " " - Deregistration Box 20 _________ _________ _________ Other Income/Deductions Box 22 _________ _________ _________ Excess Amount Box 24 _________ _________ _________ Spousal (Y/N) Box 26 _________ _________ _________ Tax Deducted Box 28 _________ _________ _________ Date Box 30 _________ _________ _________ Name & S.I.N. of Spouse ________________________________________________ *************************************************************************** T4RSP - Statement of Registered Retirement Savings Plan Income ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Annuity payments Box 16 _________ _________ _________ Refund of premiums Box 18 _________ _________ _________ Refund of excess amounts Box 20 _________ _________ _________ Withdrawals Box 22 _________ _________ _________ Spousal (Y/N) Box 24 _________ _________ _________ Deemed receipt on dereg Box 26 _________ _________ _________ Other income/deductions Box 28 _________ _________ _________ Tax deducted Box 30 _________ _________ _________ Non-Qualified Investment Box 32 _________ _________ _________ Deemed receipt on death Box 34 _________ _________ _________ Received due to death of spouse?(Y/N) __ __ __ Name & S.I.N. of Contibutor spouse ____________________________________ *************************************************************************** T4U - Statement of Unemployment Insurance Benefits Paid ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Total Benefits Box 14 _________ Income tax deducted Box 22 _________ *************************************************************************** TFA1 Statement of Family Allowances ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Name & S.I.N. of Recipient________________________________________________ Family allowance payments Box 14 _________ Number of children Box 15 ___ Number of children under 7Box 17 ___ *************************************************************************** T5 - Statement of Investment Income ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Payer _____________ ____________ ____________ _____________ ____________ ____________ Taxable dividends Box 11 _________ _________ _________ Cdn source interest Box 13 _________ _________ _________ Other income from Canadian sources Box 14 _________ _________ _________ Gross foreign income Box 15 _________ _________ _________ Foreign tax paid Box 16 _________ _________ _________ Cdn source royalties Box 17 _________ _________ _________ Capital gains dividends Box 18 _________ _________ _________ Accrued income:Annuities Box 19 _________ _________ _________ Additional Information ^^^^^^^^^^^^^^^^^^^^^^ Interest on Tax Refund Received in 1991 -------- *************************************************************************** Annual Accrual Form for Compound Interest Canada Savings Bonds ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Face Change Reported Interest Series: Value in in prior shown on Year/No ($100's) Method years T600 1989 S44 Uncashed ______ ___ _________ Cashed . Cashed ______ _________ _________ 1988 S43 Uncashed ______ ___ _________ Cashed . Cashed ______ _________ _________ 1987 S42 Uncashed ______ ___ _________ Cashed . Cashed ______ _________ _________ 1986 S41 Uncashed ______ ___ _________ Cashed . Cashed ______ _________ _________ 1985 S40 Uncashed ______ _________ Cashed . Cashed ______ ___ _________ _________ 1984 S39 Matured ______ _________ _________ *************************************************************************** T600 - Coupon Payments on Bonds ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ -----------------Payer----------------- Amount ________________________________________ --------- ________________________________________ --------- ________________________________________ --------- ________________________________________ --------- ________________________________________ --------- ________________________________________ --------- ________________________________________ --------- Bonus interest on Canada Savings Bonds --------- *************************************************************************** T778 - Calculation of Child Care Expenses Deduction ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ -- Part 1 Supporting person: -------------------------------------------------- Eligibility: To be eligible to claim child care expenses you must meet one of the following conditions below ( ) (a) You are the only supporting person. ( ) (b) There is a supporting person and your net income before child care expenses is less than that of the other supporting person. ( ) (c) There is another supporting person and your net income before child care expenses is greater than that of the other supporting person and you incurred child care expenses for a period in which: ( ) (i) the supporting person was in full-time attendance at a designated educational institution; or ( ) (ii) the supporting person, for a period of at least two weeks was infirm; or ( ) (iii) the supporting person, for a period of at least two weeks was in a prison or similar institution; or ( ) (iv) you were separated and living apart from the supporting person for at least 90 days because of a breakdown in your marriage or similar relationship. If Box b or c - Supporting person's Name,SIN,Net income: ----------------Name----------------- ---SIN--- -Net income- -# weeks- _____________________________________ __________ ___________ _____ -- Part 2 Eligible children: -------------------------------------------------- 2(A) Eligible children born after 1984 or disabled children of any age: ------------Name of Child------------ --Impairment- -Birthdate- -# weeks- _____________________________________ _____________ ___________ _____ _____________________________________ _____________ ___________ _____ _____________________________________ _____________ ___________ _____ _____________________________________ _____________ ___________ _____ (B) Eligible children born before 1985, or if born before 1977 and infirm but not included in 2(A) above: ------------Name of Child------------ --Infirmity-- -Birthdate- -#weeks- _____________________________________ _____________ ___________ _____ _____________________________________ _____________ ___________ _____ _____________________________________ _____________ ___________ _____ _____________________________________ _____________ ___________ _____ -- Part 3 Limitations --------------------------------------------------------- Limitation A - Child care expense payments ---Child----- Individual/Organization ------Address------- ---SIN--- -Amount- _____________ _______________________ ____________________ _________ _______ _____________ _______________________ ____________________ _________ _______ _____________ _______________________ ____________________ _________ _______ _____________ _______________________ ____________________ _________ _______ _____________ _______________________ ____________________ _________ _______ _____________ _______________________ ____________________ _________ _______ _____________ _______________________ ____________________ _________ _______ _____________ _______________________ ____________________ _________ _______ _____________ _______________________ ____________________ _________ _______ Limitation A - Total payments _______ *************************************************************************** T1 GSTC Goods & Services Tax Credit Application Form ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Did you reside with an "Other Supporting Person" at the end of 1991 (Y/N) ___ How many "Qualified Children" did you have at the end of 1991 ___ Are you eligible for an "Equivalent to Married" credit for one of your children ? (Y/N) ___ If someone was an "Other Supporting Person" of your "Qualified Children", what is that person's S.I.N. ? _____________ *************************************************************************** Form 1 - Self Employment Report ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Amount of salary paid to your spouse in fiscal year _________ Complete the following for the business with the largest total income: Remittance account #. . _______________ Business name . . . . . ______________________________ Location. . . . . . . . ______________________________ ______________________________ ______________________________ Briefly describe the major function of this operation: ______________________________ ______________________________ Has the major activity changed since last return was filed? ____ If the major business activity involves the resale of goods, indicate whether: ____ 0/Not Applicable 1/Retail 2/Wholesale If the major business activity involves trucking, are you also an "owner-operator", "leased-operator" or "broker-operator" working for a trucking concern: ____ 0/Not applicable 1/No 2/Yes List principal products and activities and show % of total income for each: 1: ______________________________ _____ % 2: ______________________________ _____ % 3: ______________________________ _____ % *************************************************************************** Form 2 - Summary of Capital Dispositions in 1991 ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Year Outlays Gain or of Acq Proceeds on Disp (Loss) Qualified Small Business Corporation No.of shares Name of Corp/Class of shares _____ ___________________________________ ____ _________ _______ _______ _____ ___________________________________ ____ _________ _______ _______ _____ ___________________________________ ____ _________ _______ _______ Qualified Farm Property Address or Legal Description __________________________________________ ____ _________ _______ _______ __________________________________________ ____ _________ _______ _______ __________________________________________ ____ _________ _______ _______ Other Securities & Properties No.of shares Name of Corp/Class of shares _____ ___________________________________ ____ _________ _______ _______ _____ ___________________________________ ____ _________ _______ _______ _____ ___________________________________ ____ _________ _______ _______ Real Estate and Depreciable Property Address or Legal Description __________________________________________ ____ _________ _______ _______ __________________________________________ ____ _________ _______ _______ __________________________________________ ____ _________ _______ _______ Bond, Debentures, Promissory Notes & Other Properties Address or Legal Description Face Maturity Value Date Name of Issuer _____ ________ _________________________ ____ _________ _______ _______ _____ ________ _________________________ ____ _________ _______ _______ _____ ________ _________________________ ____ _________ _______ _______ Personal Use Property (full description) __________________________________________ ____ _________ _______ _______ __________________________________________ ____ _________ _______ _______ Listed Personaal Property (full description) __________________________________________ ____ _________ _______ _______ Capital loss arising from reduction in Business Investment loss _________ Total Amount of Reserves from form T2017 _________ Taxable Capital Gain onDisposition of Eligible Capital Ppty - Other _________ *************************************************************************** Form 3 - RRSP Contributions ^^^^^^^^^^^^^^^^^^^^^^^^^^^ Plans for Self: Contributions in 1991 _________ _________ _________ Contributions in first 60 days of 1992 _________ _________ _________ Spousal Plans: Contributions in 1991 _________ _________ _________ Contributions in first 60 days of 1992 _________ _________ _________ *************************************************************************** Form 4 - Carrying Charges ^^^^^^^^^^^^^^^^^^^^^^^^^ Interest expense: on money borrowed to earn interest, dividend and royalty income --------- on money borrowed to acquire an interest in a limited partnership or a partnership in which you are not an active partner --------- on money borrowed to earn other inv. income --------- Management or safe custody fees --------- Safety deposit box charges --------- Accounting fees --------- Investment counsel fees --------- Other (specify): ______________________________ --------- *************************************************************************** Form 5 - Other Deductions ^^^^^^^^^^^^^^^^^^^^^^^^^ Repayments of Canada or Quebec pension plan _________ Repayments of old age security and/or family allowances _________ Repayments of unemployment insurance benefits _________ Repayments of scholarships _________ Legal expenses to collect salaries, wages or pension benefits_________ Legal expenses to appeal income tax assessments of prev.years_________ Legal expenses to collect alimony or maintenance arrears _________ Canadian motion picture film and videotape write-offs _________ Other deductions arising from T4RIF _________ Other deductions arising from T4RSP _________ Other (specify): ______________________________ _________ *************************************************************************** Form 6 - Additional Personal Amounts ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Equivalent to Married: Marital Status on Dec 31, 1991 _____________ If marital status changed in 1991, date of change _____________ Did you maintain the dwelling where dependent resided (Y/N) __ Did you reside in the dwelling where dependent resided (Y/N) __ Net Income of Dependent _________ Name ________________________________________ Relationship _________ Address ________________________________________ Date of Birth _________ ________________________________________ Nature of infirmity (if any) _________________ Amounts for Other Dependents: Date of Relation- Net Nature of Name ______________________________ Birth ship Income Infirmity Address ______________________________ ______________________________ ________ ________ _______ ________ Name ______________________________ Address ______________________________ ______________________________ _________ ________ _______ _________ *************************************************************************** Form 7 - Tuition Fees ^^^^^^^^^^^^^^^^^^^^^ Self: Tuition Fees Paid _________ _________ _________ Number of Months _________ _________ _________ Dependent: Name of Dependent _________ _________ _________ Disable (Y/N) ___ ___ ___ Tuition Fees Paid _________ _________ _________ Number of Months _________ _________ _________ *************************************************************************** Form 8 - Medical Expenses ^^^^^^^^^^^^^^^^^^^^^^^^^ Date Paid Name of patient- --Payment made to- --Describe expense-- --Amount- _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ _________ ________________ __________________ ____________________ ________ Premiums paid to non-government medical or hospital care plans:________ Name of plan _____________________________________________ *************************************************************************** Form 9 - Charitable Donations ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Name of organization: Amount _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ _________________________________________________ ________ Donations carried forward from last five years: ________ Gifts to Canada or a Province ________ *************************************************************************** Form 10- Federal Supplements, Social Assistance & Workers' Compensation ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Other Supporting Self Spouse Person Net federal supplements _________ _________ _________ Social assistance Payments _________ _________ _________ Workers' compensation payments _________ _________ _________ Net Income (from line 236) _________ _________ *************************************************************************** Form 11- Ontario Tax Credits ^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Rental Payments in 1991: # of Rent/Ppty Name of Landlord/ Address Rent/Own Months Tax Paid Municipality _____________________ __ ___ _________ _________________ _____________________ __ ___ _________ _________________ College Residence (# of months) _____ Ontario Political Contributions ___________ OHOSP Contributions - Self ___________ - Spouse ___________ ***************************************************************************