T1 Information Request Form Please complete the following form and correct any erroneous information

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1 T1 Information Request Form Please complete the following form and correct any erroneous information 1 Personal Information Name SIN Date of Birth Phone (Bus) Taxpayer Name: Spouse Name: Address Alberta Phone (Res) Marital Status Married Single Common-law Separated Divorced Widowed If married or common-law, should your tax return be filed jointly with your spouse`s return? Is this the first time we are preparing your tax return? If yes, provide a copy of last year`s return Address Change Has your primary residence address changed in the last year? If yes, please fill in the following information: New Address: Did you move your residence in order to earn salary, wages or self-employment income, or to attend an educational institution, in a new location in Canada? Did your move result in your new residence being at least 40 km closer than your former residence, or former educational institution, to your new place of work or business or educational institution? Did you cease your business or employment at the former location or cease attending your former eucational institution? te: If you answered to each of the proceeding questions, you may be able to deduct your moving expenses from the income earned at the new location Please also fill in the additional Moving Expenses Checklist form 2 Elections Canada The taxpayer authorizes the CRA to provide his/her name, address, and date of birth to Elections Canada to update his/her information on the National Register of Electors 3 Foreign Reporting Did the taxpayer own or hold foreign property with a total cost of more than $100,000 CAN at any time during the year? Page 1 of 11 Report Generated on: Saturday, January 09, 2016

2 4 Change in Personal or Financial Situation During the Year Did the taxpayer's marital status change during the year? Did the taxpayer immigrate to Canada or emigrate from Canada during the year? If yes, provide date of entry into Canada or, date of departure Did the taxpayer become deceased during the year? If yes, date of death: Did the taxpayer become bankrupt during the year? Did the taxpayer refinance a business with new or revised debt? Did the taxpayer close a bank account or investment account? If yes, provide details: 5 Dependents Name Relationship Date of Birth SIN Disabled? Income 6 Employment Income Did the taxpayer earn income from employment? If yes, are the T4 slips attached? Did the taxpayer receive employment insurance? If yes, is the T4E slip attached? Did the taxpayer received workers compensation? If yes, is the T5007 slip attached? Did the taxpayer receive taxable benefits not shown on the T4 slip? (auto, low-interest loans) If yes, how much? (ignore if reported on T4): Did the taxpayer receive any employment income in the form of tips and gratuities? If yes, how much? (ignore if reported on T4): Did the taxpayer receive any employment income in the form of commissions? If yes, how much? (ignore if reported on T4): Page 2 of 11 Report Generated on: Saturday, January 09, 2016

3 Did the taxpayer receive a GST rebate? If yes, amount received: 7 Employment Deductions Did the taxpayer pay union / professional dues? If yes, provide details: Is the taxpayer claiming deductable employment expenses? If yes, is a signed T2200 attached? Does the taxpayer participate in an employee profit sharing plan? If yes, is T4PS slip attached? 8 Self Employment Expense Deductions Home Office Employment Deductions To deduct home office employment expenses, you must be able to answer to one of the following questions: Are you required by your employer to maintain a work space in your home? Are you an employed salesperson earning commissions and maintaining a work space in your home? Are you self-employed with a business that you are running out of your home? In addition, you must also meet at least one of the these two tests; (1) the work space in your home is your principal place of business; or (2) the work space is used exclusively for the purpose of earning income from a business and is used on a regular and continuous basis to meet clients, customers, or patients Are you eligible for home office employment deductions? Automobile Employment Deductions To deduct automobile employment expenses, you must be able to answer to one of the following questions: Are you required by your employer to use your own vehicle for travel to work places away from your employer`s place of business? Are you self-employed and using your personal vehicle for business purposes? Are you eligible for automobile employment deductions? Other Employment Deductions To deduct other employment expenses, you must be able to answer to the following questions: Does your employer specifically require you to incur these costs as part of your employment contract? Page 3 of 11 Report Generated on: Saturday, January 09, 2016

4 Are you eligible for other employment deductions? If you are eligible to deduct Self-Employment expenses please fill out the additional 'Self-Employment Expenses' form and provide your T2200 slips where applicable 9 Pension & Retirement Income Did the taxpayer receive Canada Pension Plan income? If yes, is the T4A(P) slip attached? Did the taxpayer receive Old Age Security income? If yes, is the T4A(OAS) slip attached? Did the taxpayer receive RRSP withdrawls? If yes, is the T4RSP slip attached? Did the taxpayer receive RRSP Periodic Payments? If yes, is the T4RSP slip attached? Did the taxpayer receive RRIF Withdrawls? If yes, is the T4RIF slip attached? Did the taxpayer receive RRIF Periodic Payments? If yes, is the T4RIF slip attached? Did the taxpayer receive Company Pension or Superannuation? If yes, is the T4A slip attached? Did the taxpayer receive Annuities? If yes, is the T4A slip attached? Did the taxpayer receive Lump-Sum Payments? If yes, is the T4A slip attached? Did the taxpayer receive Retiring Allowances? If yes, is the T4A slip attached? Did the taxpayer receive US Social Security? If yes, are the reporting slips and related documents attached? Did the taxpayer receive Pensions from Foreign Sources? If yes, are the reporting slips and related documents attached? Page 4 of 11 Report Generated on: Saturday, January 09, 2016

5 10 RRSP Contributions & Pension Related Deductions If you made RRSP contributions last year and up to March 1 (February 29) of this year, this section applies to you Also, if you retired last year and received a retiring allowance, or if you used your RRSP to buy a house, this section applies to you Supply the documents and the date as appropriate Did taxpayer make RRSP contributions last year? If yes, are official RRSP receipts attached? contributed to own RRSP contributed to spousal RRSP Did taxpayer make RRSP contributions in 1st 60 days of this year? If yes, are official RRSP receipts attached? contributed to own RRSP contributed to spousal RRSP Did the taxpayer roll retiring allowance into RRSP? If yes, is the T2097 slip attached? Did the taxpayer use RRSP to purchase a house last year? If yes, is the T1036 slip attached? Did the taxpayer make Home Buyer`s Plan repayments? If yes, is the letter received by Revenue Canada attached? Did the taxpayer use RRSP to fund education last year? If yes, is the RC96 slip attached? Did the taxpayer make RRSP Lifelong Learning repayments last year? If yes, is the letter received by Revenue Canada attached? 11 Capital Gains & Losses If you bought or sold any "property" last year, it is likely you should consider the subject of captial gains and losses Property, as it is described in the Income Tax Act, covers a lot of ground It can range from real estate to mutual funds, from a loan to your bother-in-law's company to that rare manuscript in your library Dispositions of these personal assets may give rise to capital gains and losses To help you identify transactions that might be of interest to the CRA, consider the following list of common transactions where capital gains and losses may be a consideration: Purchases and Sales of Real Estate, including rental property and property held for investment purposes? If yes, please fill out 'Investment Deductions' section of this form Purchases and Sales or property that is defined as Listed Personal Property, including: a print, etching, drawing, painting, sculpture, or other similiar work of art; jewellery; a rare folio, manuscript, or book; a stamp; or a coin? Debt to a Canadian Controlled Private Corporation that is uncollectable? Shares in a bankrupt or insovent Canadian Controlled Private Corporation? Purchases and Sales of Mutual Funds and Shares? In each such transaction, standard information is required to complete your tax return or to update your lifetime records Page 5 of 11 Report Generated on: Saturday, January 09, 2016

6 Much of this information can be obtained from the legal documentation, invoicing, and agreements usually produced by these transactions, so it's often best to supply copies of these documents Whatever its format, here is the information we will require: Amount of the original purchase; Date of the purchase; Costs associated with the purchase - legal fees, Amount of the sale proceeds; Date of sale; Costs associated with the sale - legal fees, commissions; 12 Investment Income If you earned investment income outside of your RRSP last year, you will have received T-slips from the payors of that investment income Here are some of the T-slips you may have received Supply these information slips as appropriate Did the taxpayer receive Interest from Bank Savings Accounts? If yes, is the T5 slip(s) attached? Did the taxpayer receive Interest from Term Deposits? If yes, is the T5 slip(s) attached? Did the taxpayer receive Interest from GIC`s? If yes, is the T5 slip(s) attached? Did the taxpayer receive Interest or Dividends from Mutual Funds? If yes, are the T3, T5 slips attached? Did the taxpayer receive Income from Foreign Sources? If yes, are the appropriate slips/documents attached? Did the taxpayer receive Interest from Canada Savings Bonds? If yes, are the T5CSB, T600 slips attached? Did the taxpayer receive Dividends If yes, is the T5 slip(s) attached? Did the taxpayer receive Interest or Dividends from Trusts? If yes, is the T3 slip(s) attached? Did the taxpayer receive Interest or Dividends from Estates? If yes, is the T3 slip(s) attached? Did the taxpayer receive Treasury Bill Investments? If yes, are the T5008, T-BD slips attached? Did the taxpayer receive Limited Partnership Income / Loss? If yes, is the sstatement of partnership income attached? Did the taxpayer receive Interest from Mortgages, tes? If yes, are the amortizarion schedules/documents attached? Page 6 of 11 Report Generated on: Saturday, January 09, 2016

7 13 Investment Deductions Did the taxpayer dispose property during the year? If so, provide the following details: Description of Property Date Acquired Date Disposed Sale Proceeds Cost Expenses of Disposal Interest Paid to earn investment income Rental Fee on safety desposit box Accounting/Legal Fees 14 Self-Employment / Business Income Was the taxpayer self-employed during the year? If yes, is (are) the appropriate self-employment statement(s) attached? If an owner/manager, did the taxpayer have a shareholder loan outstading during the year? If yes, provide details of borrowings and repayments : If you were self-employed during the year, please fill out the 'Expenses Deductible For Income Tax Purposes By Self-Employed Individuals' form 15 Rental Income Did the taxpayer have rental income? If yes,is a statement of rental income attached? If you have rental income, please fill out the 'Rental Income' form Page 7 of 11 Report Generated on: Saturday, January 09, 2016

8 16 Property Tax / Rent Credit In some provinces, there is an education property tax credit up to $40000 based upon total property tax or rent paid In addition, a school tax credit for homeowners is also available in some circumstances For homeowners, the $40000 education property tax credit is usually deducted directly from the annual property tax bill and no further credit is available However, there can be circumstances such as changing residences or attaining age 65 that may entitle you to additional credit To ensure that no credits are overlooked please provide a copy of your property tax bill, or complete the following : Address 1 # of months resident Total Property Tax Paid Education Property Tax Credit Received School Tax Paid Address 2 # of months resident Total Property Tax Paid Education Property Tax Credit Received School Tax Paid For renters, the education property tax credit is provided through the personal income tax return Please provide rent receipts or complete the following: Address 1 # of months resident Rent Paid Name of Landlord Address 2 # of months resident Rent Paid Name of Landlord Address 3 # of months resident Rent Paid Name of Landlord Page 8 of 11 Report Generated on: Saturday, January 09, 2016

9 Only one education property tax credit is allowed per residence If you shared accommodation with one or more individuals, only one of you can claim the education property tax credit for that residence for the time you were sharing Please provide the name of any individual (other than spouse, common-law partner and/or dependent children) who shared accomodation with you 17 Other Income, Other Deductions Often less obvious items on the tax return are overlooked or ignored, usually because they may be of small dollar amounts Safety desposit box charges are a good example of this You should take the approach that no deduction is too small After all, Canada Customs and Revenue Agency never takes the position that you can ignore reporting income that is "too small" Here's a reminder list Supply the amounts, the documents, and the official receipts as appropriate: Tuition fees for self? If yes, is the appropriate Tslip attached? Tuition fees transfered from spouse/children? If yes, is the appropriate Tslip attached? Taxpayer pay interest on a student loan? Are appopriate details disclosed in an attached schedule? Alimony and maintenance payments received? Alimony and maintenance payments made? Scholarships, prizes and research grants? Child care expenses? Charitable expenses? Are the donation slips attached? Are any charitable donations made by way of gifting an item in-kind? Any loans associated with the charitable donation? Political donations? Page 9 of 11 Report Generated on: Saturday, January 09, 2016

10 Medical expenses? Costs of attendant care? Union and professional dues? Interest paid on borrowed money used to earn income? Interest paid to buy Canada Savings Bonds on a payroll savings plan? Safety deposit box charges? Fees for the management or safe custody of investments? Accounting and bookkeeping fees for keeping records of investments? Investment Counselling Fees? Legal costs to collect or establish a right to salary, wages, alimony, maintenance payments? Legal and accounting costs incurred to fight Revenue Canada? Gains from theft or embezzlement? Tax paid by installments? If yes, please complete the 'Tax Installments' section below 18 Tax Installments Based on your previous income tax returns, you were required to make quarterly income tax installments Please indicate below the payments made Alternatively, provide the statement from Canada Customs and Revenue Agency showing the payments made March 15 $ June 15 $ September 15 $ December 15 $ Page 10 of 11 Report Generated on: Saturday, January 09, 2016

11 19 Prior Year Tax Return Information / Correspondence Is a copy of last year's tax return attached? Is a copy of the tice of Assessment for last year's tax return attached? Are you a new client of the firm? If yes, are tax returns for the last three years (and correspong tices of Assessment) attached? Other than the tice of Assessment for your tax return, did you receive any other correspondes from the Canada Revenue Agency? Is a copy of this correspondence attached? Page 11 of 11 Report Generated on: Saturday, January 09, 2016

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