Income Tax Questionnaire Form

A trustee has the responsibility to file 3 tax fillings on your behalf. This includes one pre-bankruptcy, one post-bankruptcy, and the year prior to the bankruptcy event. The pre-bankruptcy tax filling is from January 1st until the day you sign into the bankruptcy. The post-bankruptcy tax filing is from the day after you file into the bankruptcy until December 31st of that calendar year. The prior year’s tax filing is for the calendar year prior to the bankruptcy event. For example, if you filed into a bankruptcy in 2021, the trustee would file your 2020 taxes on your behalf if you have not yet filed. The form below is for the prior year’s tax filing. There is no additional fee for this service.

    Tax Year:

    Personal Information:

    Name:
    Social Insurance Number:
    Street Address:
    City:
    Postal Code:
    Date of Birth (M/D/Y):
    Marital Status:
    Last year return filed:

    Spouse of Common-Law Partner Information:

    Name:
    Social Insurance Number:
    Date of Birth (M/D/Y):
    Net Income:

    Dependants (If more space is required, please attach separate sheet):

    Name:
    Date of Birth (M/D/Y):
    Net Income:
    Relationship:
    Name:
    Date of Birth (M/D/Y):
    Net Income:
    Relationship:
    Name:
    Date of Birth (M/D/Y):
    Net Income:
    Relationship:
    Did your spouse claim dependants? YesNo

    Please indicate which of the following you have for taxable income (provide copies of all slips that apply):

    Employment Income (T4) YesNo
    Employment Insurance (T4E) YesNo
    Old Age Security (OAS) YesNo
    CPP Benefits (T4AP) YesNo
    RSP Income (T4RSP) YesNo
    Other Pension Income (T4A) YesNo
    Investment Income (T3 or T5) YesNo
    Rental Income YesNo
    Business Income YesNo
    Disposition of Taxable Property YesNo
    Disposition of Investments YesNo
    Universal Child Care Benefit (UCCB) YesNo
    Other Income (please specify)
    YesNo

    Add additional document (if required)

    Please indicate which tax credits you claim:

    Do you claim the Disability tax credit? (supply disability form) YesNo
    Did you, your spouse or dependant attend a post-secondary institution? YesNo
    Did your family incur medical expenses? (supply receipts) YesNo
    Did you pay health premiums through work or privately? (supply amount) YesNo
    Does your spouse have unused tax credits? (supply copy of spouse return) YesNo
    Did you make any charitable donations? (supply receipts) YesNo
    Did you make any political contributions? (supply receipts) YesNo
    Did you enroll children in any physical activities? (supply receipts) YesNo
    Do you have receipts for a Public Transit Passes? (supply receipts) YesNo
    Do you pay rent and/or property tax? (If so, indicate annual amount) YesNo

    Add additional document (if required)

    Deductions:

    Did you make any RSP contributions? (supply receipts) YesNo
    Did you incur any childcare expenses? (supply receipts) YesNo
    Did you incur any employment related expenses? (supply receipts) YesNo
    Did you pay any professional or union dues? (supply receipts) YesNo

    Add additional document (if required)

    Other:

    Did you pay any installments on your income tax? YesNo
    Do you owe a previous balance to Canada Revenue Agency? YesNo

    Please provide this office with the following documents (If applicable):

    1. Copy of previous year’s tax return
    2. Copy of spouse or dependant’s tax return, if already filed
    3. Information on disposition of taxable property i.e.: sale price, cost of property and any related expenses
    4. Information on rental property i.e.: rent collected; expenses incurred
    5. Information on business i.e.: Income, expenses incurred
    6. Information relating to you, your spouse or dependants attending a post-secondary institution
    7. (T2202)
    8. Receipts relating to medical expenses
    9. Amount of medical premiums paid on health plan
    10. Information on disposal of investments i.e.: sale price, cost of investment
    11. Information slips:

    Signature:By typing your name in the signature box you are signing this document and confirming all of the information herein is complete and accurate.

    Date:

    If you have any questions regarding this form, please contact our office. After clicking “submit”, the trustee will review and submit your tax filing on your behalf. If they require additional information, the trustee will contact you.