Please fill out the following form

Tax Year to be Filed
New ClientPrior Client
Name
Social Insurance No.
Address
Home Phone
Cell Phone
Email
Date of Birth
Marital Status On Dec 31st of Tax Year
IF your Marital Status Change during the year:
Date:
Prior Status
Spouse's Name
Social Insurance No.
Spouse Date of Birth
Are we preparing a return for your spouse? YesNo
IF No, what was their Net Income
IF Yes, would you like to:
Pension Split YesNo
Family Tax Cut YesNoIf you qualify.
Please List Each of Your Dependent Children
Name
Date of Birth
Income
Name
Date of Birth
Income
Name
Date of Birth
Income
Name
Date of Birth
Income
Name
Date of Birth
Income
Are we preparing a return for any of your dependents YesNo
IF Yes, list which ones
Do you own any Foreign Assets OUTSIDE of Canada?YesNo
IF Yes, What type of foreign asset?
Owned with Spouse YesNo
Where is the foreign asset located?
Value of the asset
Is there any income generated from this asset? YesNo
Total for Tax Year.
Did you pay Rent or Property tax during the year? YesNo
Total paid in the year
Rent
Prop Tax
In which Province
Have you borrowed from your RRSP to buy a home or go back to school?YesNo
IF Yes, Home Buyers Repayment
Life Long learning Repayment
Does anyone pay or receive support payments? YesNo
Court Order Dated
IF Yes, Paid by
Spousal Amount
Child Amount
Received by
Spousal Amount
Child Amount
Does anyone qualify for the following Credits?
Family Caregiver Amount
For whom
CCRA Approved Disability Credit
For whom
First Time Home Buyers
Closing Date
Did you or your (C/L) spouse own a home since 2009? YesNo
Has anyone else claimed any amount towards the $5000 credit?YesNo
If Yes $
Healthy Homes Senior Home Renovation Tax Credit
Total Paid
Renovations completed
Date Contracted


Did you pay any of these expenses for your children?
Child Care
Amount Paid
ORReceipts Attached
If more than one child list amount per child
Childrens Fitness Credit
Amount Paid
OR Receipts Attached
If more than one child list amount per child
Ontario Activity Credit
Amount Paid
OR Receipts Attached
If more than one child list amount per child
Arts Tax Credit
Amount Paid
ORReceipts Attached
If more than one child list amount per child
Did anyone pay tuition in the year?
YesNo
If the taxpayer is unable to use the full tuition
Carry Forward OR
Transfer to:
Was the tuition reimbursed by anyone?
By Whom
Amount
Did you dispose of property in 2016?
YesNo
If yes: Was this the only property owned by you during the entire period of ownership?
YesNo
Proceeds of Sale
Year Purchased
FULL Address (incl postal)
Please Check Off Any Of The Following Items Paid throughout the year
Charitable Donations
Amount Paid
OR Receipts Attached Qty:
Did you or your (C&L) spouse claimed any donations since 2009?YesNo
Interest on Student Loans
Amount Paid
ORReceipts Attached Qty:
Medical Expenses
Amount Paid
ORReceipts Attached Qty:
Public Transit Passes
Amount Paid
OR Receipts Attached Qty:
Tax Paid By Installments
Amount Paid
OR Receipts Attached Qty:
Union Dues / Professional Fees
Amount Paid
OR Receipts Attached Qty:
Please Check Off Any Informations Slips You are Attaching and the Quantity of Each Slip
RC62 Qty
RRSP Qty
T2202A Qty
T3 Qty
T4 Qty
T4A Qty
T4A (OAS) Qty
T4A (P) Qty
T4RIF Qty
T4RSP Qty
T4E Qty
T5 (OAS) Qty
T5007 (P) Qty
T5008 Qty
T5013 Qty
Other
Please Check Off Any That Apply and Supply Addition Documents listed
Employment Expenses

Final and Trust Returns

Moving Expenses

Post Bankruptcy Returns

Rental Property

Self Employed Income

Please Read and Sign

Signed
Dated