2021 Provisional Tax Questionnaire

If you are filing a Proposal in 2021, our office must prepare the required 2021 provisional income tax return. This questionnaire must be filled out completely and accurately. Please note, if this form is not completed in its entirety, we will NOT file a Provisional Income Tax Return along with your Proposal and any debt owed to CRA for 2021 will be your responsibility. Also, if the information is not correct or incomplete, our office will not be responsible for filing the return incorrectly as we use the information that you provide to us. There will be an additional charge if the Trustee has to file a T1 Adjustment due to missing or incorrect information.

If you have questions or concerns regarding this form, please contact our office.

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Social Insurance Number

Name

First Name Middle Name Last Name

Did your last name change in 2021?

Yes No

Prior Last Name

Gender in 2021

Male Female

Date of Birth

Date

Phone Number

Area Code Phone Number

Email

example@example.com

Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Do you live in a different province than your mailing address?

Yes No

Province of Residence

Are you a Canadian Citizen?

Yes No

Can we provide you information to Elections Canada?

Yes No

Is your income in 2021 Zero?

Yes No

Were you confined to prison or a similar institution for a period of 90 days or more in 2021?

Yes No

Marital Status as of December 31, 2020

Has your marital status changed in 2020?

Yes No

Previous Marital Status

Month of Change

Do you have dependant children?

Yes No

Spouse Social Insurance Number

Spouses Name

First Name Middle Name Last Name

Did their last name change in 2021?

Yes No

Their Prior Last Name

Gender in 2021

Male Female

Date of Birth

Date

2021 Total Net Income

If you do not provide you spouse's net income to date for 2020, we will disclose your spouse's net income as being equal tot he 2019 basic personal amount of federal non-refundable tax credit of $12,069

Are you eligible to receive the Child Tax Benefit?

Yes No

Are you eligible to claim any dependents?

Yes No

Please provide the following information for dependents you are claiming on your income tax return

Last Name

First Name

Relationship

Date of Birth

Care Giver Amount

Dependent 1

Dependent 2

Dependent 3

Dependent 4

Dependent 5

Dependent 6

Dependent 7

Did you receive Spousal Support payments in 2021?

Yes No

Who did you receive payments? Name

Their address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Their Social Insurance Number

How much did you pay them to date?

Did you pay Spousal Support in 2021?

Yes No

Who did you make payments to? Name

Their address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Their Social Insurance Number

How much did you pay them to date?

Please provide the most recent pay stub, this will show the most up to date income information, including the required deductions. Should your income not come from an employer (I.e. pension), please provide bank statements showing the amounts that have been deposited up to date.

Self Employed – If you had self-employment earnings in 2020, please complete the T2125 up to the day prior to signing with all income and expenses as it pertains to you. Please DO NOT send in receipts, invoices, bank statements, notes, spreadsheets, etc. The Trustee will simply rely on the completed T2125. However, you are entitled to keep the supporting documentation in the event the CRA chooses to audit your 2021 Provisional return.

Please upload documents or pictures of documents

Browse Files

Have you collected EI/CERB/CRB in the 2021 year?

Yes No

How much?

2021 RRSP Contributions

Yes No

RRSP Contributions

Please enter the dates and amounts you have contributed in 2020

Statements showing RRSP contributions

Browse Files

Child Care Expenses

Yes No

From Date

Date

To Date

Date

Receipts for Child Care Expenses

Browse Files

Student Loan interest paid

Yes No

Attach interest receipt

Browse Files

Medical Expenses

Yes No

Medical receipts

Browse Files

Union, Professional dues not reported on T4

Yes No

Official tax receipt

Browse Files

Donations and Gifts

Yes No

Official tax receipts

Browse Files

Disability Tax Credit

Yes No

Who is it for?

Is this your first year claiming it?

Yes No

Attach proof of Disability Certificate from My CRA account

Browse Files

Tuition Tax Credit

Yes No

Attach tax form

Browse Files

Northern Tax Credit

Yes No

Attach form T2222

Browse Files

Alberta Climate Action Incentive

Yes No

Who will be claiming it?

Myself My spouse/Common law

Canada Workers Benefit (Previously Working Income Tax Benefit)

Yes No

Home Buyer's Amount

Yes No

Is this the first year claim it?

Yes No

The amount you are claiming?

Your credit amount?

Tax paid by installment

Yes No

Installment Payments

Please enter the dates and amounts you have contributed in 2020

If you sold property in 2021 that was, at any time, your principal residence, you must report the sale on your 2021 income tax return and you will be required to provide the Trustee with a completed Schedule 3 - Capital Gains or Losses in 2021 and a Form T2091(IND) - Designation of a Property as a Principal Residence by an Individual (Other Than a Personal Trust). If you require these forms, please request them from the Trustee.

Thank you for completing the 2021 Income Tax Questionnaire. By completing and submitting this form, it allows the tax preparer to file an accurate provisional income tax return for the Debtor for 2021.

We will not be providing copies of income tax returns unless requested. If you require paper copies, there will be an additional charge.

2021 Provisional Income Tax Questionnaire

Personal Information

Spouse Information

Dependent Information

2021 Income to date

2021 Deductions and Tax Credits to date