Information Return for Electronic Filing of an Individual's Income Tax and Benefit Return
Tax year:
Name
First name
Last name
Social insurance number
Mailing address: Apt number Street number Street name
PO Box
RR
City
Prov./Terr
Postal code
Signature (If you are unable to sign for your device, please type your name in Part 2)
Part 2 (Please clear signature above)
Name and title of legal representative
Year
Month
Day
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Should be Empty: