T1 Checklist - 2012

I. PERSONAL INFORMATION
If there has been any change since 2011 in your personal information please complete the applicable section below: If we prepared your return in 2011, and there is no change to your personal information, then you can move to Area II below. (Ta !a"e# 1$ NAM : !!!!!!! !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! A""# $$: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! $%&IA' IN$(#AN& N(M) #: !!!!!!!!!!!!! "A* %+ )I#*,: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

"I" -%( M%. "(#IN/ *, - A#0 !!! 1#%.IN& %+ # $I" N& %N " & M) # 21, 2012: !!!! MA#I*A' $*A*($: !!!!!!!!!! A# -%( A (.$ &I*I3 N %# /# (Ta !a"e# 2$ I+ MA##I " %# &%MM%N 'A4 5 NAM %+ $1%($ : !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! A""# $$ 6If different from above7: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! $%&IA' IN$(#AN& N(M) #: !!!!!!!!!!!!!!!!!!!!! "A* %+ )I#*,: !!!!!!!!!!!!!!!!!!!!!!! A# -%( A (.$ &I*I3 N %# /# N&A#" ,%'" #0 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! N&A#" ,%'" #0 !!!!!!!!!!!

1,%N N(M) # 6,ome7 !!!!!!!!!!!!!!!!64or87!!!!!!!!!!!!!!!!! 6&ellular7!!!!!!!!!!!!!!!!!!!! 6+a97!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 6 5mail address7 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! %EPEN%ANTS " 1 N"AN* 1 NAM A""# $$ I+ "I++ # N* +#%M -%(#$ "A* %+ )I#*, 5 ":M:# 'A*I%N$,I1 *% -%( *(I*I%N + $ !!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!!!! " 1 N"AN* 2 !!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!! " 1 N"AN* 2 !!!!!!!!!!!!!! !!!!!!!!!!!!!! !!!!!!!!!!!!!! !!!!!!!!!!!!!! !!!!!!!!!!!!!! !!!!!!!!!!!!!!

&,I'" $(11%#* I+ 1(#$(AN* *% A 1# 5MA- 1, 1;;< A/# M N* !!!!!!!!!!!!!!!!!!!!

II.

FOREI&N PROPERT'(

"id you own or hold forei=n property with an a==re=ate cost of >100,000 or more durin= the year0 !!!!!!!!!!!! "id you 6either alone, with related persons or with fewer than si9 &anadian residents7 have an interest of 10? or more in a non5resident corporation0 !!!!!!!!!!!! Are you the beneficiary of, or have you loaned funds to a non5resident trust0 !!!!!!!!!!!!
I) s*+ !lease a,-ise an, .e .ill c*ntact "*/ t* hel! "*/ ,ete#0ine i) "*/ a#e s/12ect t* the )*#eign #e!*#ting #e3/i#e0ents.
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T1 Checklist - 2012
All*. Cana,a Re-en/e Agenc" t* /!,ate the Nati*nal Registe# *) Elect*#s. -es!!!!!!! No!!!!!!!!!

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T1 Checklist - 2012
Check i) A!!lica1le
INFORMATION RE45IRE%

Chec III.

INCOME If you received income from any of the sources listed below please attach the information reBuired: q $alary or 4a=es or &ommissions or "irectorCs or %ther +ees or #etirin= q q q q q q q q q q q q q q q q q q q q q q q q Allowance %ld A=e $ecurity 1ension, &anada 1ension, %ther +orei=n pensions 6includin= ($ $ocial $ecurity7 (nemployment Insurance )enefits "ividends and interest 6&anada $avin=s )onds, ban8s etc.7 +orei=n "ividends and interest "ividends and interest 6 state or *rust income, *rust &ompanies etc.7 %ther Interest 5 Mort=a=e, loans, other securities and Income *a9 #efunds Annuities 6indicate if received amount due to the death of your spouse7 #ental Income $elf5employed &apital /ains or 'osses )usiness:1rofessional Income 'imited 1artnership Income or 'oss 6include financial statements7 4ithdrawal of ##$1 +unds Amounts received from ($ I#AFs Alimony, $eparation Allowances $cholarships or #esearch /rants 1rofit $harin= 1lans #e=istered #etirement Income +unds %ther Income /uaranteed Income $upplement G $pouseFs AllowancesG 4elfare and %ther $ocial Assistance 1aymentsG 4or8ersF &ompensation 1aymentsG
Althou=h the followin= amounts are not ta9able, they are considered to be income for purposes of determinin= your eli=ibility for credits and if a dependent.

*D or *DA *DA6%A$7, *DA617, 'ist details *D( *@, *E00 'ist or forei=n slips *2 'ist:bro8era=e slips:details *DA or list $ee attached form $ee attached form "etails Income $tatement *@012, *@012 $617 *D #$1 'ist "etails *DA 6or list7 *2", *D1$ *D#I+ 'ist or *DA 'ist, *DA6%A$7 'ist, *DA6%A$7 'ist or *@00< 'ist or *@00<

Check i) A!!lica1le
DEDUCTIONS AND CREDITS If you made any of the followin= types of payments, please attach the information reBuired. q #e=istered 1ension 1lan contributions or #e=istered #etirement $avin=s 1lan &ontributions q Annual 1rofessional or (nion "ues q &hild &are 9penses
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INFORMATION RE45IRE%

*D or %fficial receipts *D or %fficial receipts #eceipts

T1 Checklist - 2012
q &hildrenCs fitness and: or arts amount q &arryin= &har=es on Investment Income 6loan interest, safety deposit bo9 q q q q q q q q q q q fees, investment fees, accountin= fees, 1ayroll &$) interest7 All income ta9es paid or payable to forei=n =overnments Insurance 1olicy 'oan interest Movin= 9penses Alimony, $eparation Allowances 'e=al fees paid to collect ta9able income such as alimony or salary &haritable "onations Medical and "ental 9penses 6includes premiums paid to private health care plans, but e9cludes e9penses for which you are reimbursed by the plans7 Adoption 9penses 1olitical "onations 1ublic *ransit 1asses $alespersonFs 9penses 6automobile, travel, entertainment, etc. 5 separate those e9penses incurred outside of &anada and those incurred within #eceipts "etails 1roof of payment *2210 from insurer #eceipts and details "etails 'ist %fficial receipts #eceipts #eceipts %fficial receipts #eceipts &ate=oriHed list of amounts:*2200

&anada with no /$* content7 q 1roperty ta9es and:or rental payments for your principal residence 6can provide a credit for low income families livin= in %ntario at the end of the year7 q Income *a9 instalment payments 6TA7 S8ELTER6 INFORMATION q If you have made a Ita9 shelteredI investment please include the applicable information.

'ist, indicatin= payee

"etails or info from &#A *@002:*@00D

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T1 Checklist - 2012
I9. OT8ER ITEMS q 4ere you a student in full5time attendance at a (niversity or &olle=e, or in a full5time correspondence course at any time durin= the year0 q 4ere any of your dependants students in full5time attendance or in a full5 time correspondence at a (niversity or &olle=e who did not use all of the tuition or education credits0 q 4ere you or any of your dependants students in full5time attendance at a forei=n (niversity or &olle=e at any time durin= the year0 q "id you or your employer contribute to a re=istered pension plan of which you are a member or a deferred profit sharin= plan of which you are a beneficiary0 q Are you, your spouse, or a dependant child severely disabled and have not previously filed a "isability *a9 &redit 6*220170 q "o you receive a motor vehicle or travel allowance that is included in your *D0 q 4ere you or your spouse in hospital for more than two wee8s and had day care e9penses0 6,i=her income spouse may be able to claim day care for time when low5income spouse incapacitated.7 q Are either you or your spouse ($ citiHens or holders of J/reen &ardsK0 (nder ($ ta9 law all such people are reBuired to file ($ income ta9 returns and report their worldwide income every year they have income. In many cases, available credits will result in little or no income ta9. ,owever, the returns must be filed in order to claim the credits. 4e can assist you in the preparation of those returns. q "o you spend si=nificant time in the ($ each year0 If so, please enter the number of days you spent in the ($, if it was over 100 days per year. q 1lease include a copy of all ta9 assessment notice6s7 received in the past year. q If /$* re=istrant, please include full /$* details includin= re=istration number. q "id you complete and renovations to improve the accessibility of your home for any seniors 6E@L, includin= yourself7 livin= there between %ct 1, 2011 and "ecember 21, 2012 'ist details 2012 !!!!!!!!! 2011 !!!!!!!!! 2010 !!!!!!!!! *2201 "etails, on what is it based "etails *2202 or *2202A $i=ned *2202 or *2202A transferrin= the credit *'11A *D or details

9.

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T1 Checklist - 2012
CHECKLIST FOR THE SELF-EMPLOYED
Advertising Convention Expenses Dis !i"it# Modi$i% tions Ins&r n%e Interest Interest nd 'orro(ing C) rges He "t) P" n Pre*i&*s Ho*e O$$i%e S+& re Foot ge o$ Ho*e O$$i%e Sp %e Rent or Mortg ge Interest Propert# t x Ho*e Ins&r n%e Ann& " ,ti"ities He t H#dro - ter C !"e . Internet Te"ep)one . Internet nd Tot " Ho*e Foot ge

M inten n%e nd Rep irs Le sing Costs Me "s . Entert in*ent Expenses A&to*o!i"e O(n or Le se - s T)ere C) nge in t)e T x Ye r /Det i"s0

I$ Le se1 Le se Cost Per Mont) I$ O(n1 Interest Cost Per Mont)

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T1 Checklist - 2012
CHECKLIST FOR THE SELF-EMPLOYED /%ont2d0
E+&ip*ent P&r%) ses S&!5e%t to CCA F&rnit&re nd E+&ip*ent Co*p&ter E+&ip*ent Le se)o"ds /i$ rent " propert#0 Odo*eter 3 'eginning o$ Ye r Odo*eter 3 End o$ Ye r Per%ent ge o$ '&siness ,se o$ C r F&e" Expenses C r Ins&r n%e Rep irs nd M inten n%e P r4ing expenses Hig)( # To""s Li%ense nd Registr tion

M.. $

O$$i%e Expenses Pro$ession " Me*!ers)ip D&es 6 Fees A%%o&nting Fees Leg " Fees /st te n t&re o$0 S " ries P id /provide T7 S&** r# $or 899:0 Tr ve" Expenses List Ot)er Expenses Te"ep)one . F x St tion r# S&pp"ies Internet

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T1 Checklist - 2012
RENTAL INCOME C8EC:LIST RENTAL PROPERT' INFORMATION "id you purchase the property durin= the year0 [yes/no]: Address &ity:1rov Number of units: Inc*0e #ental income E !enses 6 !#*-i,e t*tal e !ense - ,* n*t !#*#ate$ 1ersonal use percenta=e Advertisin= Insurance Mort=a=e interest 6provide Mort=a=e statement from lendin= company7 #epairs and maintenance &ondominium fees Mana=ement and administration fees Automobile e9pense 6if claim more then one rental property7 %ffice e9penses 'e=al, accountin= and other professionals fees 1roperty ta9es $alary, wa=es and benefits *ravel ,eat lectri city 4ater &able *. N Internet 6paid by you7 $ecurity 'andscapin=:snow removal )an8 char=es %ther 6provide details7 *%*A' 1ostal &ode -our 1artnership ? :

ALSO INCLUDE: O Mort=a=e statement from lendin= company.

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T1 Checklist - 2012
O $tatement of adPustment 6in the year of purchase or dispose of property7.

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