Protected B
when completed
Tax Withholding Waiver on Accumulated
Income Payments from RESPs
Refer to the back of this form for information on how to complete it.
Identification
Last name (print)
First name and initials (print)
Social insurance number
Address
Part of the accumulated income payment (AIP) that qualifies for a waiver of tax deductions
1
1. AIP you are entitled to receive from this RESP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
2
2. RRSP/PRPP deduction limit shown on your notice of assessment for the preceding year . . . . .
3
3. Amount from line 1 or 2, whichever is less . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
4
4. Allowable lifetime limit: maximum amount for which a waiver can be authorized for
all years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
5
–
5. Total of all amounts used to reduce the amount of additional tax payable on all AIPs
received in previous years (if applicable). This amount is the total of the amount entered at
line 5 of all T1172 forms you filed for 1998 and at line 7 of all T1172 forms you filed for
1999 and later years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
6. Line 4 minus line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
=
$
7
7. Total of all AIPs that you contributed or had your promoter transfer to your RRSP, PRPP,
or SPP or your spouse's or common-law partner's RRSP or SPP so far this year to reduce
the amount of AIPs subject to the additional tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
–
8
8. Line 6 minus line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
=
$
◄
9
9. Enter the amount from line 3 or line 8, whichever is less. This is the part of the AIP on
which the promoter is authorized to not withhold tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
Details of transfer
From:
RESP name
RESP contract number
Amount transferred
$
To:
RRSP, PRPP, or SPP name
RRSP, PRPP, or SPP account number
Tick the box that applies to the RRSP:
Your RRSP
Your PRPP
Your SPP
Your spouse's or
common-law
partner RRSP or
SPP
Certification of subscriber or spouse or common-law partner of a deceased subscriber
I certify that I will deduct the amount transferred to my RRSP, PRPP, or SPP or my spouse's or common-law partner's RRSP or SPP on my income tax and
benefit return for the year I received the AIP. I also certify that the issuer of the RRSP, PRPP, or SPP has advised me that the plan is registered, or that the
issuer will apply to register the RRSP under the Income Tax Act.
Signature of subscriber (or signature of spouse or common-law partner of a deceased subscriber)
Year Month Day
Certification of promoter
I certify that I have verified the subscriber's RRSP/PRPP deduction limit, or spouse's or common-law partner's RRSP/PRPP deduction limit in the case of a
deceased subscriber. I also certify that I will transfer an amount that is not more than the amount indicated on line 9, on behalf of the individual, directly to the
RRSP, PRPP, or SPP stated above and that I will report the amount transferred.
Signature of authorized person
Year Month Day
Personal information, including the social insurance number, is collected under the Income Tax Act to assess individual income tax for the federal government
and the provinces and territories. It can be used for audit, compliance, or evaluation purposes and shared or verified with other federal and provincial/territorial
government institutions. Failure to provide the information may result in interest payable, penalties, or other actions. Under the Privacy Act, individuals have a
right to and shall, on request, be given access to their personal information and to request correction of it; refer to InfoSource (www.infosource.gc.ca) personal
information bank CRA PPU 005.
T1171 E (14)
(Vous pouvez obtenir ce formulaire en français à www.arc.gc.ca/formulaires ou en composant le 1-800-959-7775.)
