Canada Child Benefits Application
Use this form to apply for all child benefit programs, including
the Canada child tax benefit (CCTB), the goods and services
tax/harmonized sales tax (GST/HST) credit, and the universal
child care benefit (UCCB). The information you give on this form
will be used for all programs, unless you indicate otherwise.
For more information about our programs, go to
www.cra.gc.ca/benefits, see Booklets T4114, Canada Child
Benefits, and RC4210, GST/HST Credit, or call 1-800-387-1193.
How do I apply?
You can apply by using "Apply for child benefits" at
www.cra.gc.ca/myaccount or by sending this completed form,
with any other required documents, to your tax centre (see
"Where do you send this form?" on the next page).
If you are the mother of a newborn and you live in a province or
a territory that offers the Automated Benefits Application (ABA)
service, you can use this service to apply for all your child benefits.
If this is the case, do not re-apply using the Canada Revenue
Agency (CRA) online service or this form. For more information on
the ABA service, go to www.cra.gc.ca/aba.
You should apply even if:
your child only lives with you part of the time (see "Do you share
custody of a child?" on the next page);
your current adjusted family net income is too high. We
recalculate your entitlement every July based on your adjusted
family net income for the previous year; or
your child is living with you for a determined temporary period of
time, for example, over the summer holidays:
A temporary change in care must be for more than 14 days
and has to include the first day of any month and the last day
of the previous month.
A temporary shared custody situation must be for a period of
at least two consecutive months and the child lives with each
individual on a more or less equal basis.
Part 1 – Information about the applicant
Who should complete Part 1?
The person who is primarily responsible for the care and
upbringing of the child should complete Part 1.
For CCTB purposes, when both a male and a female parent live
in the same home as the child, the female parent is usually
considered to be primarily responsible for the care and
upbringing of the child (defined on the next page) and should
apply. However, if the male parent is primarily responsible, he can
apply if he attaches to his application a signed note from the female
parent that states he is primarily responsible for all of the children in
the household.
Supporting documents
Once we receive your application, we may ask you to provide
supporting documents to prove you are primarily responsible for
the care and upbringing of the child, such as:
a signed statement from a nursery or school authority confirming
the child's home address and guardian on record;
a signed statement from a person in a position of authority
(such as a lawyer or a social worker);
a registration form or a receipt from an activity or club the child
was enrolled in for the period you indicated; or
a court order, decree or separation agreement.
You do not have to provide these documents with your application
however, if you choose to do so, we may still contact you if we need
more information.
Does your application include a period that started more than
11 months ago?
If so, you must attach clear photocopies of both sides of all pages of
the following documents for the entire period that started more than
11 months ago:
proof of citizenship status (for example, a Canadian birth
certificate) or immigration status in Canada for you and your
spouse or common-law partner, if you have one;
proof that you resided in Canada, such as a lease agreement,
rent receipts, utility bills, or bank statements;
proof of birth for each child (see Part 3 below); and
proof that you were the person who is primarily responsible
for the care and upbringing of the child(ren) (defined on the
next page) (see "Supporting documents" on this page).
Note
If your application is late, you may not get payments for the entire
period requested.
What is your current marital status?
Tick "Married" if you have a spouse. Tick "Living common-law" if
you have a common-law partner. If you have been separated for
less than 90 days, you are still considered to be married or living
common-law. For more information, see the definitions on the
next page.
Part 2 – Information about your spouse or
common-law partner
Complete Part 2 of the application only if you ticked box 1 or 2 in
Part 1.
Part 3 – Information about the child(ren)
Complete this part to provide information about the child(ren).
Do not provide information about a child for whom you have
already applied, unless the child left your care and has now
returned.
When do you need to provide proof of birth?
You need to attach proof of birth for the child if we have not
previously paid benefits to anyone for this child, and any of the
following applies:
the child was born outside Canada; or
the child was born in Canada and is one year of age or older.
Attach clear photocopies of both sides of all pages of one of the
following documents for proof of birth:
birth certificate or birth registration;
hospital record of birth or record of the physician, nurse,
or midwife who attended the birth;
passport;
Record of Landing or Confirmation of Permanent Residence
issued by Citizenship and Immigration Canada;
citizenship certificate; or
Notice of Decision or a Temporary Resident's Permit issued
under the Immigration and Refugee Protection Act.
RC66 E (14)
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Do you share custody of a child?
A child lives with two different individuals in separate residences on
a more or less equal basis. For example:
the child lives with one parent four days a week and the other
parent three days a week;
the child lives with one parent one week and the other parent
the following week; or
any other regular cycle of alternation.
In these cases, both individuals may be considered primarily
responsible for the child's care and upbringing when the child lives
with them. Each individual will get 50% of the payment he or she
would have received if the child lived with him or her all of the time.
If you have just entered into a shared custody situation for your
child(ren), you have to apply for the CCTB by using "Apply for child
benefits" at www.cra.gc.ca/myaccount or by sending us this
completed form.
If you already get the CCTB, you have to tell us by using
"Apply for child benefits" at www.cra.gc.ca/myaccount, by sending
us this completed form indicating shared custody, by calling
1-800-387-1193, or by sending us a letter explaining the shared
custody situation. Your payments will be recalculated accordingly.
Part 4 – Change of recipient
Complete this part if the child(ren) had been living with another
individual or were maintained by an agency.
Part 5 – Certification
Sign and complete this part. If you completed Part 2, your spouse or
common-law partner also has to sign and complete this part.
Direct deposit
You can have your payments deposited directly into your account
at a financial institution in Canada. To get this service or change
your banking information, go to www.cra.gc.ca/myaccount or
attach a completed direct deposit enrolment form. To obtain a direct
deposit enrolment form, go to www.cra.gc.ca/directdeposit or call
1-800-387-1193.
Child and family benefits online calculator
You can use our online calculator to get an estimate of your
child benefits by going to www.cra.gc.ca/benefits-calculator.
Definitions
Common-law partner – this applies to a person who is not your
spouse (defined on this page), with whom you are living in a
conjugal relationship, and to whom at least one of the following
situations applies. He or she:
a) has been living with you in a conjugal relationship, and this
current relationship has lasted at least 12 continuous months;
Note
In this definition, 12 continuous months includes any period you
were separated for less than 90 days because of a breakdown in
the relationship.
b) is the parent of your child by birth or adoption; or
c) has custody and control of your child (or had custody and
control immediately before the child turned 19 years of age)
and your child is wholly dependent on that person for support.
Primarily responsible for the care and upbringing of a child
this means that you are responsible for such things as supervising
the child's daily activities and needs, making sure the child's medical
needs are met, and arranging for child care when necessary. If there
is a female parent who lives with the child, we usually consider her
to be this person.
Note
You may not be considered primarily responsible for the care
and upbringing of the child if the child is legally, physically, or
financially maintained by a child welfare agency. For more
information, follow the "Children's special allowances (CSA)"
link at www.cra.gc.ca/benefits and select "CSA fact sheet" or
call 1-800-387-1193.
Separated – you are separated when you start living separate
and apart from your spouse or common-law partner because of a
breakdown in the relationship for a period of at least 90 days and
you have not reconciled.
Once you have been separated for 90 days (because of a
breakdown in the relationship), the effective day of your separated
status is the date you started living separate and apart.
Spouse – this applies only to a person to whom you are legally
married.
For more information
For more information, go to www.cra.gc.ca/benefits or
call 1-800-387-1193.
To get our forms and publications, go to www.cra.gc.ca/forms or
call 1-800-387-1193.
Where do you send this form?
Send this completed form and any documents to the tax centre that
serves your area. Use the chart below to get the address.
If your tax services office is
located in:
Send your correspondence
to the following address:
British Columbia, Regina or Yukon
Surrey Tax Centre
9755 King George Boulevard
Surrey BC V3T 5E1
Alberta, London, Manitoba,
Northwest Territories, Saskatoon,
Thunder Bay, or Windsor
Winnipeg Tax Centre
PO Box 14005, Station Main
Winnipeg MB R3C 0E3
Barrie, Sudbury (the area of
Sudbury/Nickel Belt only),
Toronto Centre, Toronto East,
Toronto North, or Toronto West
Sudbury Tax Centre
1050 Notre Dame Avenue
Sudbury ON P3A 5C1
Laval, Montréal, Nunavut, Ottawa,
Rouyn-Noranda, Sherbrooke,
or Sudbury (other than the
Sudbury/
Nickel Belt area)
Shawinigan-Sud Tax Centre
PO Box 3000, Station Main
Shawinigan-Sud QC G9N 7S6
Chicoutimi, Montérégie-Rive-Sud,
Outaouais, Québec, Rimouski,
or Trois-Rivières
Jonquière Tax Centre
PO Box 1900, Station LCD
Jonquière QC G7S 5J1
Kingston, New Brunswick,
Newfoundland and Labrador,
Nova Scotia, Peterborough,
or St. Catharines
St. John's Tax Centre
PO Box 12071, Station A
St. John's NL A1B 3Z1
Belleville, Hamilton,
Kitchener/Waterloo, or
Prince Edward Island
Summerside Tax Centre
102 – 275 Pope Road
Summerside PE C1N 5Z7
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Protected B
when completed
Canada Child Benefits Application
Do not use this area
Use this form to apply for all child benefit programs. Send it, and any other required documents, to your tax
centre (see "Where do you send this form?" on the attached information sheet).
Complete the parts that apply to you (please print).
Part 1 – Information about the applicant
When both a male and a female parent live in the same home, we usually consider the female parent to be the applicant.
First name and initial Last name Social insurance number
Last name at birth (if different from above)
Female Male
Date of birth:
Year
Month
Day
Your language of correspondence:
Votre langue de correspondance :
English Français
City
Province or territory
Postal code
Home address (if different from mailing address) (Apt No – Street No Street name, RR)
City
Province or territory
Postal code
Home telephone number Work telephone number
If you moved from a different province or territory, enter the previous province or territory:
If you moved to the province or territory within the last 12 months, enter the date you moved:
Year
Month
Day
Does your application include a period that started more than 11 months ago?
If yes, see the first page of the attached information sheet to find out which documents you need to attach.
Yes No
Have you been a Canadian citizen for the last 12 months?
If no, you must attach a completed Schedule RC66SCH, Status in Canada/Statement of Income.
Yes No
You must also attach a completed Schedule RC66SCH if you or your spouse or common-law partner:
became a new resident or returned as a resident of Canada in the last 2 years; or
are, as defined in the Immigration and Refugee Protection Act, a permanent resident, protected person (refugee), or temporary resident who has lived in
Canada for the previous 18 months.
Tick the box that applies to your current marital status (tick only one box). For definitions, see the second page of the attached information sheet.
1
Married
2
Living common-law
3
Widowed
4
Divorced
5
Separated
6
Single
Enter the date your current marital status began (if you ticked box 2 or 5 above, see the definitions for common-law partner
and separated on the attached information sheet to determine the date you must enter):
Year
Month
Day
Mailing address (Apt No – Street No Street name, PO Box, RR)
Part 2 – Information about your spouse or common-law partner
First name and initial Last name Social insurance number
Last name at birth (if different from above)
Date of birth:
Year
Month
Day
Female Male
If your spouse or common-law partner's address is different from yours, please explain:
Has your spouse or common-law partner been a Canadian citizen for the last 12 months?
If no, you must attach a completed Schedule RC66SCH, Status in Canada/Statement of Income.
Yes No
RC66 E (14) (Vous pouvez obtenir ce formulaire en français à www.arc.gc.ca/formulaires ou en composant le 1-800-387-1194.)
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Part 3 – Information about the child(ren)
To find out if you need to attach proof of birth, see the first page of the attached information sheet.
Child information (Do not include children for whom you have already applied or for whom you already get benefits.)
First name Initial Last name
Female Male
Place of birth – City Province or territory (or country if outside Canada)
Date of birth:
Year
Month
Day
Enter the date you became primarily responsible for the care and upbringing of this child.
For the definition of primarily responsible for the care and upbringing of a child,
see the second page of the attached information sheet.
Year
Month
Day
Are you in a shared custody situation for this child?
See "Do you share custody of a child?" on the second page of the attached information sheet.
Yes No
Child information (Do not include children for whom you have already applied or for whom you already get benefits.)
First name Initial Last name
Female Male
Place of birth – City Province or territory (or country if outside Canada)
Date of birth:
Year
Month
Day
Enter the date you became primarily responsible for the care and upbringing of this child.
For the definition of primarily responsible for the care and upbringing of a child,
see the second page of the attached information sheet.
Year
Month
Day
Are you in a shared custody situation for this child?
See "Do you share custody of a child?" on the second page of the attached information sheet.
Yes No
Child information (Do not include children for whom you have already applied or for whom you already get benefits.)
First name Initial Last name
Female Male
Place of birth – City Province or territory (or country if outside Canada)
Date of birth:
Year
Month
Day
Enter the date you became primarily responsible for the care and upbringing of this child.
For the definition of primarily responsible for the care and upbringing of a child,
see the second page of the attached information sheet.
Year
Month
Day
Are you in a shared custody situation for this child?
See "Do you share custody of a child?" on the second page of the attached information sheet.
Yes
No
If you are applying for more than three children, attach a separate sheet of paper
with the information requested above for the additional child(ren) and sign it.
Part 4 – Change of recipient
Complete this part if the child(ren) had been living with another individual or maintained by an agency.
Name, address, and telephone number of previous caregiver or agency Name of child(ren)
Part 5 – Certification
I certify that the information given on this form and in all documents attached is, to the best of my knowledge, correct and complete.
Applicant's signature
It is a serious offence to make a false statement.
Date
yyyy-mm-dd
Spouse's or common-law partner's signature
It is a serious offence to make a false statement.
Date
yyyy-mm-dd
Privacy Act, personal information bank number CRA PPU 005, CRA PPU 063, and CRA PPU 140
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