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Income Tax Benefit Return | Application

   

Added on  2022-07-29

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Protected B when completed
2019Income Tax and Benefit Return
ON 7
Before you start:
If you are filling out this return for a deceased person, make sure you enter their information in all the boxes in Step 1.
Step 1 – Identification and other information
Identification
Print your name and address below.
First name and initial
Last name
Mailing address: Apt No. – Street No. Street name
PO Box RR
City Prov./Terr. Postal code
Email address
By providing an email address, you are registering to receive
email notifications from the CRA and agree to the Terms of use
under Step 1 in the guide.
Enter an email address:
Information about your residence
Enter your province or territory of
residence on December 31, 2019:
Enter the province or territory
where you currently reside if it is
not the same as your mailing
address above:
If you were self-employed in 2019,
enter the province or territory
where your business had a
permanent establishment:
If you became or ceased to be a resident of Canada for
income tax purposes in 2019, enter the date of:
entry
Month Day
or departure
Month Day
Information about you
Enter your social
insurance number (SIN):
Enter your date of birth:
Year Month Day
Your language of correspondence:
Votre langue de correspondance :
English Français
Is this return for a deceased person?
Ensure the SIN information above is for the deceased person.
If this return is for a
deceased person, enter the
date of death:
Year Month Day
Marital status
Tick the box that applies to your marital status on
December 31, 2019:
1 Married 2 Living common-law 3 Widowed
4 Divorced 5 Separated 6 Single
Information about your spouse or
common-law partner (if you ticked box 1 or 2 above)
Enter their SIN:
Enter their first name:
Enter their net income for 2019
to claim certain credits:
Enter the amount of universal child
care benefit (UCCB) from line 11700
of their return:
Enter the amount of UCCB repayment
from line 21300 of their return:
Tick this box if they were self-employed in 2019: 1
Do not use this area
Do not use
this area 17200 17100
5006-R Page 1
0 4 6 4 5 4 2 8 6
Rosy 1 9 8 2 1 0 1 2
Evans X
1234-Street
Roseville O N N 1 A 1 A 1
X
Ontario
Ontario
DUPLICATE - DO NOT SEND BY MAIL
Name: Rosy Evans SIN:046 454 286 Printed on:2020/04/19 06:47 EDT
Income Tax Benefit Return | Application_1

Protected B when completed
Step 1 – Identification and other information (continued)
Please answer the following questions.
Elections Canada (For more information, see "Elections Canada" under Step 1, in the guide.)
A) Do you have Canadian citizenship? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Yes 2No
If yes, go to question B. If no, skip question B.
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 or, if
you are aged 14 to 17, to update the Register of Future Electors? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Yes 2No
Your authorization is valid until you file your next tax return. Your information will only be used for purposes permitted under
the Canada Elections Act, which include sharing lists of electors produced from the National Register of Electors with
provincial and territorial electoral agencies, members of Parliament, registered and eligible political parties, and candidates
at election time.
Your information in the Register of Future Electors will be included in the National Register of Electors once you turn 18.
Information from the Register of Future Electors can be shared only with provincial and territorial electoral agencies that are
allowed to collect future elector information. In addition, Elections Canada can use information in the Register of Future
Electors to provide youth with educational information about the electoral process.
Indian Act – Exempt income
Tick this box if you have any income that is exempt under the Indian Act.
For more information on this type of income, go to canada.ca/taxes-aboriginal-peoples. 1
If you tick the box, get and complete Form T90, Income Exempt under the Indian Act. Complete this form so that the CRA
can calculate your Canada training credit limit for the 2020 tax year. The information you provide may also be used to
calculate your Canada workers benefit for the 2019 tax year, if applicable.
Foreign property
26600
Did you own or hold specified foreign property where the total cost amount of all such
property, at any time in 2019, was more than CAN$100,000? .. . . . . . . . . . . . . . . . . . . . . . 1Yes 2No
If yes, get and complete Form T1135, Foreign Income Verification Statement. There are substantial penalties for not
completing and filing Form T1135 by the due date. For more information, see Form T1135.
5006-R Page 2
X
X
X
DUPLICATE - DO NOT SEND BY MAIL
Name: Rosy Evans SIN:046 454 286 Printed on:2020/04/19 06:47 EDT
Income Tax Benefit Return | Application_2

Protected B when completed
Attach only the documents (schedules, information slips, forms, or receipts) requested to support
any claim or deduction. Keep all other supporting documents.
Step 2 – Total income
As a resident of Canada, you have to report your income from all sources both inside and outside Canada.
The Income Tax and Benefit Guide may have additional information for certain lines.
10100Employment income (box 14 of all T4 slips)
10105
Tax-exempt income for emergency services volunteers
(See line 10100 in the guide.)
10120Commissions included on line 10100 (box 42 of all T4 slips)
10130Wage-loss replacement contributions (See line 10100 in the guide.)
10400Other employment income +
11300Old age security pension (box 18 of the T4A(OAS) slip) +
11400CPP or QPP benefits (box 20 of the T4A(P) slip) +
11410Disability benefits included on line 11400 (box 16 of the T4A(P) slip)
11500
Other pensions and superannuation (See line 11500 in the guide and complete line 31400 in the
Worksheet for the return.) +
11600Elected split-pension amount (Get and complete Form T1032.) +
11700Universal child care benefit (UCCB) (See the RC62 slip.) +
11701UCCB amount designated to a dependant
11900Employment insurance and other benefits (box 14 of the T4E slip) +
11905
Employment insurance maternity and parental benefits and provincial
parental insurance plan benefits
12000
Taxable amount of dividends (eligible and other than eligible) from taxable Canadian corporations
(Complete the Worksheet for the return.) +
12010
Taxable amount of dividends other than eligible dividends, included on
line 12000, from taxable Canadian corporations
12100Interest and other investment income (Complete the Worksheet for the return.) +
12200Net partnership income: limited or non-active partners only +
12500Registered disability savings plan income (box 131 of the T4A slip) +
Rental income 12599Gross 12600Net +
12700Taxable capital gains (Complete Schedule 3.) +
Support payments received 12799Total 12800Taxable amount +
12900RRSP income (from all T4RSP slips) +
13000Other income Specify: +
13010Taxable scholarship, fellowships, bursaries, and artists' project grants +
Self-employment income
Business income 13499Gross 13500Net +
Professional income 13699Gross 13700Net +
Commission income 13899Gross 13900Net +
Farming income 14099Gross 14100Net +
Fishing income 14299Gross 14300Net +
14400Workers' compensation benefits (box 10 of the T5007 slip)
14500Social assistance payments +
14600Net federal supplements (box 21 of the T4A(OAS) slip) +
14700Add lines 14400, 14500, and 14600. (See line 25000 in Step 4.) =
+
15000This is your total income.
Add lines 10100, 10400 to 11400, 11500 to 11700, 11900, 12000,
12100 to 12500, 12600, 12700, 12800, 12900 to 13010, 13500, 13700,
13900, 14100, 14300, and 14700. =
5006-R Page 3
7,000 00
5,600 00
110,400 00 52,795 00
24,000 00
30,000 00 (5,000 00)
84,395 00DUPLICATE - DO NOT SEND BY MAIL
Name: Rosy Evans SIN:046 454 286 Printed on:2020/04/19 06:47 EDT
Income Tax Benefit Return | Application_3

Protected B when completed
Step 3 – Net income
15000Enter your total income from line 15000 from the previous page.
20600
Pension adjustment (box 52 of all T4 slips and
box 034 of all T4A slips)
20700
Registered pension plan deduction
(box 20 of all T4 slips and box 032 of all T4A slips)
20800RRSP deduction (See Schedule 7 and attach receipts.) +
20810
Pooled registered pension plan (PRPP)
employer contributions (amount from your
PRPP contribution receipts)
21000Deduction for elected split-pension amount (Get and complete Form T1032.) +
21200Annual union, professional, or like dues (receipts and box 44 of all T4 slips) +
21300Universal child care benefit repayment (box 12 of all RC62 slips) +
21400Child care expenses (Get and complete Form T778.) +
21500Disability supports deduction (Get and complete Form T929.) +
Business investment loss 21699Gross 21700Allowable deduction +
21900Moving expenses (Get and complete Form T1-M.) +
Support payments made 21999Total 22000Allowable deduction +
22100
Carrying charges and interest expenses
(Complete the Worksheet for the return.) +
22200
Deduction for CPP or QPP contributions on self-employment and other
earnings (Complete Schedule 8 or get and complete Form RC381,
whichever applies.) +
22215
Deduction for CPP or QPP enhanced contributions on employment income
(Complete Schedule 8 or get and complete Form RC381, whichever applies.) +
22400Exploration and development expenses (Get and complete Form T1229.) +
22900Other employment expenses +
23100Clergy residence deduction (Get and complete Form T1223.) +
23200Other deductions Specify: +
23300
Add lines 20700, 20800, 21000 to 21500, 21700, 21900, 22000, and
22100 to 23200. =

23400This is your net income before adjustments.Line 15000 minus line 23300 (if negative, enter "0") =
23500
Social benefits repayment (If you reported income at line 11900 and the amount at line 23400 is
greater than $66,375, see the repayment chart on the back of your T4E slip. If you reported income
on lines 11300 or 14600, and the amount at line 23400 is greater than $77,580, complete the chart
for line 23500 on the Worksheet for the return. Otherwise, enter "0".)
23600This is your net income.Line 23400 minus line 23500 (if negative, enter "0") =
5006-R Page 4
84,395 00
7,000 00
84,395 00
84,395 00
DUPLICATE - DO NOT SEND BY MAIL
Name: Rosy Evans SIN:046 454 286 Printed on:2020/04/19 06:47 EDT
Income Tax Benefit Return | Application_4

Protected B when completed
Step 4 – Taxable income
24400Canadian Forces personnel and police deduction (box 43 of all T4 slips)
24900Security options deductions +
25000
Other payments deduction (Claim the amount from line 14700, unless it
includes an amount at line 14600. If so, see line 25000 in the guide.) +
25100Limited partnership losses of other years +
25200Non-capital losses of other years +
25300Net capital losses of other years +
25400Capital gains deduction (Get and complete Form T657.) +
25500Northern residents deductions (Get and complete Form T2222.) +
25600Additional deductions Specify: +
25700Add lines 24400 to 25600. =

26000This is your taxable income.Line 23600 minus line 25700 (if negative, enter "0") =
5006-R Page 5
84,395 00
DUPLICATE - DO NOT SEND BY MAIL
Name: Rosy Evans SIN:046 454 286 Printed on:2020/04/19 06:47 EDT
Income Tax Benefit Return | Application_5

Protected B when completed
Step 5 Federal tax (formerly Schedule 1)
Part A Federal non-refundable tax credits
30000 1Basic personal amount claim $12,069
30100 2
Age amount (if you were born in 1954 or earlier)
(Complete the Worksheet for the return.) (maximum $7,494) +
30300 3Spouse or common-law partner amount (Complete Schedule 5.) +
30400 4Amount for an eligible dependant (Complete Schedule 5.) +
30425 5
Canada caregiver amount for spouse or common-law partner, or eligible dependant
age 18 or older (Complete Schedule 5.) +
30450 6Canada caregiver amount for other infirm dependants age 18 or older (Complete Schedule 5.) +
Canada caregiver amount for infirm children under 18 years of age
30499Enter the number of children for whom you are claiming this amount. × $ 2,230 = 30500 7+
Base CPP or QPP contributions:
30800 8
through employment income
(Complete Schedule 8 or get and complete Form RC381, whichever applies.) +
31000 9
on self-employment and other earnings
(Complete Schedule 8 or get and complete Form RC381, whichever applies.) +
Employment insurance premiums:
31200 10through employment from box 18 and box 55 of all T4 slips (maximum $860.22) +
31217 11on self-employment and other eligible earnings (Complete Schedule 13.) +
31220 12Volunteer firefighters' amount +
31240 13Search and rescue volunteers' amount +
31260 14
Canada employment amount (Enter $1,222 or the total of your employment income you reported
on lines 10100 and 10400, whichever is less.) +
31270 15Home buyers' amount +
31285 16Home accessibility expenses (Complete the Worksheet for the return.) (maximum $10,000) +
31300 17Adoption expenses +
31400 18Pension income amount (Complete the Worksheet for the return.) (maximum $2,000) +
31600 19
Disability amount (for self)
(Claim $8,416 or if you were under 18 years of age, complete the Worksheet for the return.) +
31800 20Disability amount transferred from a dependant (Complete the Worksheet for the return.) +
31900 21Interest paid on your student loans (See Guide P105.) +
32300 22Your tuition, education, and textbook amounts (Complete Schedule 11.) +
32400 23Tuition amount transferred from a child +
32600 24Amounts transferred from your spouse or common-law partner (Complete Schedule 2.) +
33099 25
Medical expenses for self, spouse or common-law partner, and
your dependent children born in 2002 or later
26Enter $2,352 or 3% of line 23600, whichever is less.
27Line 25 minus line 26 (if negative, enter "0") =
33199 28
Allowable amount of medical expenses for other dependants
(Complete the Worksheet for the return.) +
33200 29Add lines 27 and 28. =
+
33500 30Add lines 1 to 24, and line 29. =
31Federal non-refundable tax credit rate × 15%
33800 32Multiply line 30 by line 31. =
34900 33Donations and gifts (Complete Schedule 9.) +
35000 34Total federal non-refundable tax credits
Add lines 32 and 33.
Enter this amount on line 46 on the next page. =
5006-R Page 6
12,069 00
6,569 00
2,000 00
5,500 00
2,352 00
26,138 00
3,920 70
4,394 50
8,315 20
DUPLICATE - DO NOT SEND BY MAIL
Name: Rosy Evans SIN:046 454 286 Printed on:2020/04/19 06:47 EDT
Income Tax Benefit Return | Application_6

Protected B when completed
Part B Federal tax on taxable income
35Enter your taxable income from line 26000.
Complete the
appropriate column
depending on the
amount on line 35.
Line 35 is
$47,630 or less
Enter the amount
from line 35.
0.00Line 36 minus line 37
(cannot be negative) =
× 15%Multiply line 38
by line 39. =
+ 0.00
Add lines 40 and 41. =
Line 35 is more
than $47,630 but
not more than
$95,259
47,630.00
=
× 20.5%
=
+ 7,145.00
=
Line 35 is more
than $95,259 but
not more than
$147,667
95,259.00
=
× 26%
=
+ 16,908.00
=
Line 35 is more
than $147,667 but
not more than
$210,371
147,667.00
=
× 29%
=
+ 30,535.00
=
Line 35 is more
than $210,371
210,371.00
=
× 33%
=
+ 48,719.00
=
36
37
38
39
40
41
42
Part C – Net federal tax
43Enter the amount from line 42.
40424 44Federal tax on split income (Get and complete Form T1206.) +
40400 45Add lines 43 and 44. =
35000 46
Enter your total federal non-refundable tax credits
from line 34 on the previous page.
40425 47Federal dividend tax credit (See line 40425 in the guide.) +
40427 48Minimum tax carryover (Get and complete Form T691.) +
49Add lines 46, 47, and 48. =
42900 50Basic federal taxLine 45 minus line 49 (if negative, enter "0") =
40500 51Federal foreign tax credit (Get and complete Form T2209.)
40600 52Federal taxLine 50 minus line 51 (if negative, enter "0") =
40900 53
Total federal political contributions
(attach receipts)
41000 54
Federal political contribution tax credit
(Complete the Worksheet for the return.) (maximum $650)
41200 55Investment tax credit (Get and complete Form T2038(IND).) +
Labour-sponsored funds tax credit
(See lines 41300 and 41400 in the guide.)
41300
Net cost of shares of a
provincially registered fund 41400 56Allowable credit +
41600 57Add lines 54, 55, and 56. =

41700 58Line 52 minus line 57 (if negative, enter "0") =
41500 59
Canada workers benefit advance payments received
(box 10 of the RC210 slip) +
41800 60Special taxes (See line 41800 in the guide.) +
42000 61Net federal tax
Add lines 58, 59, and 60.
Enter this amount on line 42000 on the next page. =
Step 6 – Provincial or territorial tax
Complete Form 428 to calculate your provincial tax.
5006-R Page 7
84,395 00
84,395 00
36,765 00
7,536 82
14,681 82
14,681 82
14,681 82 14,681 82
8,315 20
8,315 20 8,315 20
6,366 62
6,366 62
6,366 62
6,366 62
DUPLICATE - DO NOT SEND BY MAIL
Name: Rosy Evans SIN:046 454 286 Printed on:2020/04/19 06:47 EDT
Income Tax Benefit Return | Application_7

Protected B when completed
42000
Step 7 – Refund or balance owing
Net federal tax: enter the amount from line 61 from the previous page.
42100
CPP contributions payable on self-employment and other earnings
(Complete Schedule 8 or get and complete Form RC381, whichever applies.) +
42120
Employment insurance premiums payable on self-employment and other eligible earnings
(Complete Schedule 13.) +
42200Social benefits repayment (amount from line 23500) +
42800Provincial or territorial tax (Attach Form 428, even if the result is "0".) +
43500This is your total payable.Add lines 42000, 42100, 42120, 42200, and 42800. =
43700Total income tax deducted (amounts from all Canadian slips)
44000Refundable Quebec abatement (See line 44000 in the guide.) +
44800CPP overpayment (See line 30800 in the guide.) +
45000Employment insurance overpayment (See line 45000 in the guide.) +
45110Climate Action Incentive (Complete Schedule 14.) +
45200
Refundable medical expense supplement
(Complete the Worksheet for the return.) +
45300Canada workers benefit (CWB) (Complete Schedule 6.) +
45400Refund of investment tax credit (Get and complete Form T2038(IND).) +
45600Part XII.2 trust tax credit (box 38 of all T3 slips and box 209 of all T5013 slips) +
45700Employee and partner GST/HST rebate (Get and complete Form GST370.) +
Eligible educator school supply tax credit
46800Supplies expenses (maximum $1,000) × 15% = 46900 +
47600Tax paid by instalments +
47900Provincial or territorial credits (Complete Form 479, if it applies.) +
48200These are your total credits.
Add lines 43700 to 45700, and
46900 to 47900. =

This is your refund or balance owing.Line 43500 minus line 48200 =
If the result is negative, you have a refund. If the result is positive, you have a balance owing.
Enter the amount below on whichever line applies.
Generally, we do not charge or refund a difference of $2 or less.


48400Refund 48500Balance owing

For more information on how to receive your refund by
direct deposit, see line 48400 in the guide or go to
canada.ca/cra-direct-deposit.
For more information on how to make your payment, see
line 48500 in the guide or go to canada.ca/payments.
Your payment is due no later than April 30, 2020.
Ontario opportunities fund
You can help reduce Ontario's debt by completing this area to
donate some or all of your 2019 refund to the Ontario opportunities
fund. Please see the provincial pages for details.
1Amount from line 48400 above
46500 2
Your donation to the
Ontario opportunities fund
46600 3Net refund (line 1 minus line 2) =

I certify that the information given on this return and in any
documents attached is correct and complete and fully discloses
all my income.
Sign here
It is a serious offence to make a false return.
Telephone number:
Date
If this return was completed by a tax professional, tick the
applicable box and provide the following information:
49000 Was a fee charged? 1Yes 2No
48900 EFILE number (if applicable):
Name of tax professional:
Telephone number:
Personal information (including the SIN) is collected for the purposes of the administration or enforcement of the Income Tax Act and related programs and
activities including administering tax, benefits, audit, compliance, and collection. The information collected may be used or disclosed for purposes of other
federal acts that provide for the imposition and collection of a tax or duty. It may also be disclosed to other federal, provincial, territorial or foreign government
institutions to the extent authorized by law. Failure to provide this information may result in interest payable, penalties or other actions. Under the Privacy Act,
individuals have the right to access their personal information, request correction, or file a complaint to the Privacy Commissioner of Canada regarding the
handling of the individual’s personal information. Refer to Personal Information Bank CRA PPU 005 on Info Source at canada.ca/cra-info-source.
Do not use
this area 48700 48800 48600
5006-R Page 8 Canada Revenue Agency Approval # : RC-19-107
6,366 62
4,152 45
10,519 07
224 00
12,000 00
12,224 00 12,224 00
(1,704 93)
1,704 93
1,704 93
1,704 93
DUPLICATE - DO NOT SEND BY MAIL
Name: Rosy Evans SIN:046 454 286 Printed on:2020/04/19 06:47 EDT
Income Tax Benefit Return | Application_8

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