Provisional Tax Questionnaire

If you are filing a Proposal in 2023, our office must prepare the required 2023 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 2023 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 NameMiddle NameLast Name

Did your last name change in 2023?

YesNo

Prior Last Name

Gender in 2023

MaleFemale

Date of Birth

Date

Phone Number

Area CodePhone Number

Email

example@example.com

Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

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

YesNo

Province of Residence

Are you a Canadian Citizen?

YesNo

Can we provide you information to Elections Canada?

YesNo

Is your income in 2023 Zero?

YesNo

Were you confined to prison or a similar institution for a period of 90 days or more in 2023?

YesNo

Marital Status as of December 31, 2022

Has your marital status changed in 2023?

YesNo

Previous Marital Status

Month of Change

Do you have dependant children?

YesNo

Spouse Social Insurance Number

Spouses Name

First NameMiddle NameLast Name

Did their last name change in 2023?

YesNo

Their Prior Last Name

Gender in 2023

MaleFemale

Date of Birth

Date

2023 Total Net Income

please provide spouse income to date for 2022

Please provide the following information for all of your dependents.

	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

Do you receive the Child Tax Benefit?

YesNo

Do you claim any dependents?

YesNo

Did you receive Spousal Support payments in 2023?

YesNo

Who did you receive payments? Name

Their address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Their Social Insurance Number

How much did you pay them to date?

Did you pay Spousal Support in 2023?

YesNo

Who did you make payments to? Name

Their address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Their Social Insurance Number

How much did you pay them to date?

Please provide any or all year to date pay stubs from all employers from January 1st, 2023 to the day before your Proposal (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 2023, 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 2023 Provisional return.

Please upload documents or pictures of documents

Browse Files

Have you collected any Employment Insurance Benefits (EI) from January 1st, 2023 to the day before your Proposal?

YesNo

If so, please disclose the total amount of EI received from January 1st, to the day before your Proposal.

2023 RRSP Contributions

YesNo

RRSP Contributions

Please enter the dates and amounts you have contributed in 2021

Statements showing RRSP contributions

Browse Files

Child Care Expenses

YesNo

From Date

Date

To Date

Date

Receipts for Child Care Expenses

Browse Files

Student Loan interest paid

YesNo

Attach interest receipt

Browse Files

Medical Expenses

YesNo

Medical receipts

Browse Files

Union, Professional dues not reported on T4

YesNo

Official tax receipt

Browse Files

Donations and Gifts

YesNo

Official tax receipts

Browse Files

Disability Tax Credit

YesNo

Who is it for?

Is this your first year claiming it?

YesNo

Attach proof of Disability Certificate from My CRA account

Browse Files

Tuition Tax Credit

YesNo

Attach tax form

Browse Files

Northern Tax Credit

YesNo

Attach form T2222

Browse Files

Canada Workers Benefit (Previously Working Income Tax Benefit)

YesNo

Home Buyer's Amount

YesNo

Is this the first year claim it?

YesNo

The amount you are claiming?

Your credit amount?

Tax paid by installment

YesNo

Installment Payments

Please enter the dates and amounts you have contributed in 2020

Please attach if "yes" was stated to any of the above.

Browse Files

If you sold property in 2023 that was, at any time, your principal residence, you must report the sale on your 2023 income tax return and you will be required to provide the Trustee with a completed Schedule 3 - Capital Gains or Losses in 2023 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 2023 Provisional Questionnaire. By completing and submitting this form, it allows the tax preparer to file an accurate provisional income tax return for the Debtor for 2023.

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

Are you sure you want to submit?*

Yes

2023 Provisional Income Tax Questionnaire

Personal Information

Spouse Information

Dependent Information

2023 Income to date

2023 Deductions and Tax Credits to date