Community Volunteer Income Tax Program Volunteer Information and Software Agreement

Complete this form and return it to your Canada Revenue Agency (CRA) coordinator.

Protected B
when completed

Volunteer information
Last name First name Telephone number Home: Other: Prov./Terr.

Postal code

Address street, apt., R.R. or P.O. box number

City or town

What language(s) do you speak? English French Other Yes No years

Your language of correspondence English French

Email address

Do you have experience completing income tax and benefit returns? How did you hear about the CVITP? Available to volunteer: days evenings weekends

Do you have experience with the Community Volunteer Income Tax Program (CVITP)? Other volunteers Media (newspapers, radio, websites, etc.)

Yes No

years

CRA website

Community organization

Other: ________________

Dates available to volunteer (January to April, year-round, etc.):

Do you have access to the Internet? Yes No

or

year-round

How do you wish to receive the software? Internet download CD

Community organization information

Name of organization Are you available to offer your services to other organizations? City or town Prov./Terr. Yes Postal code No

Address street, apt., R.R. or P.O. Box number

Contact name

Telephone number

Email address Does the organization have Internet access? Yes No

ext:

Volunteer and software agreement

As a volunteer with the Community Volunteer Income Tax Program, I agree to: protect the taxpayer's privacy by never using or divulging any information provided by the taxpayer for any purpose other than the preparation of his or her income tax and benefit return; offer my services free of charge and decline any monetary reward that may be offered to me; return the completed income tax and benefit return to the taxpayer or community organization; not keep any copies of a taxpayer's income tax and benefit return (paper or electronic); have the taxpayer sign Form TIS60, Community Volunteer Income Tax Program Taxpayer Authorization and return it to the taxpayer; only use the Community Volunteer Income Tax Program tax software to prepare returns for eligible taxpayers; not use the tax software for monetary gain; not copy or allow copies to be made of the tax software; encrypt taxpayers' returns using the tax software and save electronic copies only on an encrypted USB flash drive, and transmit the return to the Canada Revenue Agency within 48 hours of preparation; and delete all electronic copies of the taxpayer's return, no later than 48 hours after its transmission to and acceptance by the Canada Revenue Agency.

I declare that I have never been convicted of a criminal offence involving evasion in the payment or remittance of tax, fraudulent transactions in which the public or any person is defrauded of property, money or valuable security or service, possession of property obtained by crime or the proceeds of crime.

Volunteer's name (print) Privacy Act, Personal Information Bank number CRA PPU 100 T242 E (13)

Volunteer's signature

Date