Protected B
when completed
Community Volunteer Income Tax Program
Taxpayer Authorization
Tax year 20
Keep this form for your records. Do not send a copy to the Canada Revenue Agency (CRA).
Complete Section I to allow a Community Volunteer Income Tax Program (CVITP) volunteer to prepare your income tax and benefit return.
Complete Section II if you would like your return to be electronically filed. The CVITP volunteer must complete parts E and F.
Keep all records used to prepare your return for a period of six years, and provide this information to the CRA on request.
The CRA is responsible for ensuring the confidentiality of your electronically filed tax information only after the CRA has accepted it.
Section I – Authorization
Part A Identification
Last name
First name
Social insurance number
(only enter last 3 digits)
Mailing address: Apt. No. – Street No. Street name
Telephone number (home)
Telephone number (work)
P.O. Box
R.R.
City
Prov./Terr.
Postal code
Part B Disclaimer
I am fully aware that my income tax and benefit return is being prepared by a volunteer under the Community Volunteer Income Tax
Program and that this volunteer is not acting as an agent of the Canada Revenue Agency.
Signature (individual identified in Part A) Date
Signed at (place and name of organization)
Section II – Electronic filing (EFILE)
Part C Declaration
Enter the following amounts from your income tax return:
Total income (line 150) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxable income (line 260) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total federal non-refundable tax credits (line 350 of Schedule 1)
Refund (line 484)
or
Balance owing (line 485)
Part D Declaration and authorization
I declare that the information entered in Part A and the amounts shown in Part C above are correct and complete, and fully discloses my
income from all sources. I also declare that I have read the information above, and the electronic filer identified in Part E is electronically
filing my income tax and benefit return.
Signature (individual identified in Part A) Date
CVITP volunteer must complete parts E and F
Part E Electronic filer identification
By signing Part D above, the individual in Part A declares that the following person or
organization is electronically filing his or her income tax return. Part D must be signed
before the return is electronically transmitted.
Name of person or organization:
Electronic filer number:
Part F Document control number
Document control number for the electronic
record of the individual's return:
Privacy Act, personal information bank number CRA PPU 100
TIS60 E (15)
Clear Data
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