Protected B when completed
Declaration of Conditions of Employment for
Working at Home Due to COVID-19
This form is only for employees who worked from their home in 2021 due to COVID-19. The employer must complete and sign
this form if the employee chooses to use the detailed method to calculate their home office expenses (work-space-in-the-home
and supplies). If the employee is required to pay for expenses other than home office expenses, do not use this form. Instead,
complete Form T2200, Declaration of Conditions of Employment.
The employee does not need to attach this form to their return, but they must keep it in case we ask to see it later. However,
the employee must complete Form T777S, Statement of Employment Expenses for Working at Home Due to COVID-19, and
attach it to their tax return to deduct home office expenses for the year.
For more information about claiming employment expenses, see Guide T4044, Employment Expenses.
Part A – Employee information
Last name First name Tax year
Employer address
Part B – Conditions of employment
1.
Did this employee work from home due to COVID-19?
Yes No
2.
Did you or will you reimburse this employee for any of their home office expenses?
Yes No
3.
Was the amount included on this employee's T4 slip?
Yes No
Employer declaration
I certify that this employee worked from home in 2021 due to COVID-19, and was required to pay some or all their own
home office expenses used directly in their work while carrying out their duties of employment during that period.
I certify that the information given on this form is, to the best of my knowledge, correct and complete.
Note: Clearly print the name and telephone number of the authorized person in case we need to call to verify information.
Name of employer Name and title of authorized person
Date
Telephone number
ext.
Signature of employer or authorized person
The employee has to complete this section if we ask them to send us this form.
Name of employee
Social insurance number
Date
Home address
See the privacy notice on your return.
T2200S E (21) (Ce formulaire est disponible en français.)
