Protected B when completed
If you are the taxpayer, you must sign and date this form.
If you are the legal representative, you must tick the box below, and sign and date this form.
I am the legal representative for this taxpayer (executor/administrator, power of attorney, the legal guardian).
As a legal representative, please make sure that you have either included or have already sent
a complete copy of the legal document that supports your authorization to the CRA before
submitting a request to change a taxpayer's address.
Name of taxpayer or legal representative(s)
Date of signature
Year Month Day
Signature of taxpayer, legal representative(s), a parent (if taxpayer is under
the age of 16), a witness (when signed with a mark)
Purpose of this form
Complete this form to notify us of a change in your mailing address or your home address or of a change in your telephone number(s).
You cannot use this form:
to notify us of a change of name
to notify us of a change in your date of birth
if you have not filed an income tax and benefit return with the Canada Revenue Agency
Why is it important?
When you tell us your new address in advance:
you can avoid a disruption in receiving your benefit payments, such as GST/HST credit payments, (including certain related
provincial payments), Canada child benefit payments (including certain related provincial or territorial payments), as well as
Canada workers benefit advance payments.
If you do not have a social insurance number but you already got an individual tax number or a temporary taxation number,
continue to use the tax number you have been issued.
Indicate your home or mailing address if it is different from what it was when you last dealt with us.
Send your completed form to your local office listed below:
Jonquière Tax Centre
PO Box 1900 Stn LCD
Jonquière QC G7S 5J1
Winnipeg Tax Centre
PO Box 14005 Stn Main
Winnipeg MB R3C 0E3
Sudbury Tax Centre
PO Box 20000 Stn A
Sudbury ON P3A 5C1
Privacy Act Notice
Personal information is collected under the Income Tax Act to administer tax, benefits, and related programs. It may also be used for any purpose
related to the administration or enforcement of the Act such as audit, compliance and the payment of debts owed to the Crown. It may be shared or
verified with other federal, provincial/territorial 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 and request correction
if there are errors or omissions. Refer to Info Source at canada.ca/arc-info-source, Personal Bank numbers CRA PPU 005 and CRA PPU 063.