Protected B when completed
Step 4 – Your spouse's or common-law partner's income
Enter your spouse's or common-law partner's income, from all sources, that was not reported on a Canadian tax return. All amounts must be
converted into Canadian dollars using the Bank of Canada exchange rate in effect when they received the income. For the exchange rates, go
to bankofcanada.ca/rates/exchange.
Enter "0" if they had no income.
If your spouse or common-law partner:
•
was a non-resident of Canada for the whole tax year, enter their income in section A
•
became a non-resident of Canada in the tax year, enter their income in section B
•
became a resident of Canada in the tax year, enter their income in section C
A – Non-resident of Canada for the whole year
If your spouse or common-law partner was a non-resident
of Canada for the whole tax year, enter their income for
the whole year:
$
B – Became a non-resident of Canada in the year
If your spouse or common-law partner became a
non-resident of Canada in the tax year, enter the date
they became a non-resident:
Year Month Day
Enter their income for the part of the tax year that they were
a non-resident of Canada:
$
C – Became a resident of Canada in the year
If your spouse or common-law partner became a resident
of Canada in the tax year, enter the date they became a
resident:
Year Month Day
Enter their income for the part of the tax year that they were
a non-resident of Canada:
$
Step 5 – Signature
I certify that the information given on this form is correct and complete. I understand that it is a serious offence to make a false statement.
Your signature
Date:
Year Month Day
Personal information (including the SIN) is collected for the purposes of the administration or enforcement of the Income Tax Act and related programs and activities including
administering tax, benefits, audit, compliance, and collection. The information collected may be used or disclosed for purposes of other federal acts that provide for the imposition
and collection of a tax or duty. It may also be disclosed to other federal, provincial, territorial or foreign 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, request correction, or file
a complaint to the Privacy Commissioner of Canada regarding the handling of the individual's personal information. Refer to Personal Information Bank CRA PPU 063 on Info
Source at canada.ca/cra-info-source
.
What do you do once your form is filled out?
Make sure all steps of this form are filled out.
Make a photocopy for your records.
Send this form with your tax return or send it to the tax centre that serves your area.
For more information
For more information on the Canada child benefit, go to canada.ca/canada-child-benefit or call 1-800-387-1193. From outside Canada or the United States,
call 1-613-940-8495. We accept collect calls by automated response.
To get the tax centre addresses, go to canada.ca/tax-centres
or call 1-800-387-1193.
