Personal Tax Intake Form

Personal Tax Intake Form
We encourage all personal clients to please read the following before filing the form:

Important information for taxpayers: READ HERE

Personal information
Are you a returning client or a new client?*

Returning ClientNew Client
Have any of your personal details changed in the past year?*

YesNo
What has changed?*

Personal InformationDependent InformationPhone NumberAddressMarital StatusEmail AddressFax

Do you have dependents?*

YesNo

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tel: Home
Please enter a valid phone number.
Tel: Office
Please enter a valid phone number.
Tel: Cell
Please enter a valid phone number.
Fax
Email*
example@example.com
Status:*

SingleMarried*SeparatedCommon-law*DivorcedSame-sex partner*Widowed
* Are you filing your returns jointly with spouse?*

YesNo
If no, please provide your spouse’s gross income for the year
Did your marital status change during the year?*

YesNo
Date of marriage or union in 2024

MonthDayYear
Date
Date of separation or divorce in 2024

MonthDayYear
Date
Do you or any members of your household have a disability?*

YesNo
If yes, do you have a completed Form T2202?*

YesNo
Did you immigrate to Canada or emigrate from Canada during 2024?*

YesNo
If yes, provide date of entry into Canada

MonthDayYear
Date
OR date of departure

MonthDayYear
Date
Are you a US citizen?*

YesNo
Are you a citizen of another country that requires you to file an income tax return or other tax information? If yes, provide details:*
Did you work outside of Canada in 2024? If yes, provide details:*
Are you self employed?*

YesNo
If yes, provide the following data
Business number
Do you want us to file your GST/HST?
If you are claiming Northern Resident Deduction, state if you lived in your address for a complete 12 months in 2024*

YesNo

Are you claiming Northern Travel or Medical?*

YesNo
Are any of Northern Travel or Medical included in box 32/33 of T4 Slips?*

YesNo

Elections Canada (must be completed by all taxpayers)
The taxpayer authorizes the CRA to provide their name, address, and date of birthto Elections Canada to update their information on the National Register of Electors?*

YesNo

Consent to share contact information – Organ and tissue donor registry(must be completed by all taxpayers resident in Ontario and Nunavut)
I authorize the CRA to provide my name and email address to Ontario Health so thatOntario Health (Trillium Gift of Life) may contact or send information to me by emailabout organ and tissue donation*

YesNo

Prior year tax return information-New Client?
Copy of prior years' personal income tax assessment (if not already provided)

YesNo
Other than the Notice of Assessment for your tax return, did you receive any other correspondence from the Canada Revenue Agency? If yes, please attach

YesNo
Are you a new client of the firm?

YesNo
If so, are tax returns and the corresponding Notice of Assessment for the last three (3) years attached?

YesNo

Income and expenses (select all that apply and attach corresponding slips and receipts)
Income:*

T4 - Employee / Commissions remunerationT4A – Other employment incomeT4E – Employment insurance & other benefitsT4PS – Profit sharing planT4A(OAS) – Old age securityT4A – Pension / Other income / COVID-19 benefitsT4A(P) – CPP / Disability benefitsT4RIF / T4RSP – RRSP incomeT3 – Trust incomeT5 – Investment / interest incomeT5013 – Partnership incomeT5008 –Statement of security transactions-G/LT600 – Ownership certificatesForeign incomeRental income (complete Schedule A)Capital gains (complete Schedule B)T2200 or T2200S - Employment expenses (signed by employer)Other employment expenses (complete Schedule D)Self-employment income (complete Schedule E)Interest on investment loans (enter details below)TRIF - Registered Retirement Inc FundT4RSP - Income from RRSPNorthern Residents (Proof of Residents)RRSP - Life Long LearningTrucker's Lodging and Meals (TL2)Sale or Deemed Sale of Stocks, Bonds, or Real EstateSold Home (Required Documents)Farm Income and Expenses

Interest on investments loans

	Bank	Interest paid	Receipts attached?
1.
2.
3.

Upload tax slips and applicable documents*

Cancelof
Deductions and/or Tax Credits*

RRSP contribution(Self and/or Spouse)Did you participate in the Home Buyer's Plan?Child care expensesAdoption expensesAccounting and/or legal feesT2202 – Tuition for self/dependent(s)Interest on student loanMedical expensesCharitable donationsPolitical contributionsAnnual union professional or like duesHST rebateSpousal support paidSpousal support receivedChild support paidChild support receivedHome Renovations (seniors and disabled)Disability Tax Credit CertificationSearch and Rescue Volunteers CertificationMedical TravelMoving ExpensesNorthern Allowance Travel or Medical (Box 32/33)Carrying Charges and Interests ExpensesOffice - In-Home ExpensesVolunteer Firefighters CertificationRRSP Home Buyer Repayment

Income tax instalments paid
Federal (CRA)
Quebec

Ontario Trillium Benefit
Please indicate the property tax and/or rent paid in Ontario in 2024
Property tax
Rent

Fill any of the following Schedules (if required)
Schedule A – Statement of Real Estate Rentals
Schedule B – Capital Gains / (Losses) for 2024 Sales
Schedule C – Disposition of a Principal Residence
Schedule D – Statement of Employment Expenses
Schedule E – Self Employment OR Professional Business Income Statement

Investment Package

We recognize that some clients may have significant and diverse range of investments slips and transactions on dividends & interests (T5s), trust income(T3), capital gains or loss (T5008) and carrying charges. This type of investment profile may require broker, advisor or financial institutions preparation of an investment portfolio's tax package, which may be sent late or incomplete

In order to properly follow up and track receipt of information for tax return:

Do you agree to share financial/investment advisor's information with us for follow up?
Investment/financial advisor's name
Financial Institution
Investment advisor's email
example@example.com
Phone no
Please enter a valid phone number.
Fill only schedules that apply to you

If you do not have your income and expenses consolidated and require us to do bookkeeping, send us your bank and cc statements and other paper works.

Alternatively, you can list out all income and expenses in an excel sheet stating date, amount, purchase sources and categories. Once sent, we will consolidate and produce tax ready statement for filing.

COMPLETE ANY OR ALL OF THE SCHEDULES, IF RELEVANT TO YOUR TAX SITUATION
Important information to read before filling the schedules

SCHEDULE A – Statement of Real Estate Rentals
Property details
Property address:

Co-owners names and percentage ownership (if any):

	Name	SIN	% of ownership
1.
2.
3.
4.

Is this property also used for personal purposes?

YesNo
If yes, what percentage?
Are you an HST registrant?

YesNo
Income

Total incl GST/HST

Gross rental income

	Total incl GST/HST
Gross rental income

Expense

	Total incl GST/HST
Advertising
Insurance
Interest and bank charges
Office expenses
Legal, accounting and other professional fees
Management and administration fees
Maintenance and repairs
Salaries, wages, and benefits (employer’s contributions)
Property taxes
School taxes
Travel
Utilities
Motor vehicle expenses (not including CCA)
Other

Total Expense

	Description of capital addition(s)	Total Cost
1.
2.
3.
4.

Send additional information in excel or pdf document version , if necessary

SCHEDULE B – Capital Gains / (Losses) for 2024 Sales

Please provide copies of the capital gain summary prepared by your broker, or if unavailable, complete the following information:

	# of shares/units	Description of property	Year purchased	Selling price (note 1) ($)	Cost base (note 2) ($)	Selling costs ($)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

Notes:
1. If you have not received all your proceeds in the current year, please provide us with details of amounts still receivable so that we may claim a reserve to defer any capital gains tax as permitted.
2. Commissions charged on the purchase of securities should be included in the determination of the cost base. For identical shares purchased after 1971, the cost base per share is determined by using the weighted average method. For shares purchased before 1972, the cost base per share is determined by using the median value of the weighted average original cost, V-day value, and current sales price.

SCHEDULE C - Disposition of a Principal Residence
Did you dispose of, or were you deemed to dispose of, your principal residence in 2024?

YesNo
(A deemed disposition would include a change in use of the principal residence i.e. from a principal residence to a rental property or a deemed disposition on the death of a taxpayer)
Proceeds of Disposition
Year of Acquisition

MonthDayYear
Date
Adjusted Cost Base of the Property
(Send Statement of Adjustment when property was intially bought and current statement of adjustment for this sale)
Address of the Property
Did you own other properties during the period of ownership that would have qualified as your principal residence? (i.e. a cottage or vacation property that you ordinarily inhabited during the period)

YesNo
Year of Acquisition of the other property

MonthDayYear
Date
Adjusted Cost Base of the other Property
Proceeds of disposition of the other Property if it has been sold
Estimated Fair Market Value of the other Property if it has not been sold
Have you ever claimed a Principal Residence Exemption in the past?

YesNo
If so for what years have you claimed an exemption in the past
Notes:
1. Prior to Dec 31, 1981 spouses could designate one property each as a principal residence;
2. Prior to 1971 tax was not payable on capital gains as such FMV of properties at such time were deemed to be taxpayers cost base.
3. Send Statement of adjustments for when sold property was initially bought and statement of adjustment documents for the sale of the property in 2024

SCHEDULE D – Statement of Employment Expenses
January 1, 2024 - December 31, 2024
You may be able to claim certain employment expenses if you have a completed Form T2200 Declaration of Conditions of Employment.
Did you work from home in 2024?

YesNo
Number of days worked from home in 2022 (include the date range)
Do you have a signed form T2200 or T2200S?

YesNo
Is your employer registered for GST/HST?

YesNo

Expenses (other than auto)

	Total incl GST/HST
Travel expenses: Food
Food subject to commissioned employee limit (note 1)
Lodging expenses
Other travelling expenses
Parking
Supplies: Stationery
Other (postage, ink cartridges, other office supplies, etc.)
Other expenses: Telecommunications (employment use of a cell phone)
Salaries paid to a substitute or assistant
Office rent

Expenses incurred to earn commission income only

	Total incl GST/HST
Legal and accounting fees other than for recovering a salary or for establishing the right to a salary
Advertising and promotion
Entertainment expenses: Food
Food subject to commissioned employee limit (note 1)
Tickets and entrance fees
Other
Other expenses: Licences
Bonding premiums
Rental of office equipment
Training costs
Travel fare
Other

Home office expenses:
Type of work space:

Designated roomCommon (shared) area

	Total incl GST/HST
Total square footage of home (sq ft)
Total square feet used for home office (sq ft)
Hours of work per week if common (shared) area (hours)
Heat ($)
Electricity ($)
Water ($)
Home internet access fees ($)
Maintenance ($)
Insurance (commission employees only) ($)
Property taxes (commission employees only) ($)
Rent ($)
Personal portion (%)

Auto expenses:

	Total incl GST/HST
Total business km driven in 2024 (note 2) (km)
Total km driven in 2024 (note 2) (km)
Fuel (gasoline, propane, oil, electricity) Maintenance ($)
and repairs ($)
Insurance ($)
Licence and registration fees ($)
Capital cost allowance ($)
Interest ($)
Leasing costs ($)
Other

Expenses (other than auto) Total
Expenses incurred to earn commission income only Total
Home office expenses Total
Auto expenses Total
Total Expense
Automobile lease:
Date lease commenced

MonthDayYear
Date
Mfg suggested retail price
Automobile purchase:
Description of vehicle
Purchase date

MonthDayYear
Date
Purchase price
GST/HST incl. in price
Reimbursements/Allowances:
Amount of reimbursements/allowances received from your employer in respect of:
Non-auto expenses
Auto expenses
Have these amounts been included in your T4 employment income or professional business income?

YesNo
Notes:
1. A meal consumed by a commissioned employee shall not be included as an expense, unless the meal was consumed during a period required by their employment duties to be away for a period of not less than 12 hours from the municipality of the employer’s establishment. Please refer to your T2200 (Part B question 3) issued by your employer to see if this rule pertains to you.
2. CRA is now insisting on a mileage log or they will disallow all automobile expenses. Please ensure that you keep appropriate records of your mileage and base the km drive on the log book.
3. Send vehicle purchase or lease document for review

SCHEDULE E – Self-Employment OR Professional Business Income Statement
January 1, 2024 - December 31, 2024
Business name
Main product/service
Are you a GST/HST registrant?

YesNo
Did you complete your GST/HST return?

YesNo

Total incl GST/HST

	Total incl GST/HST
Income: Professional income (sales, commissions, fees) $
Cost of goods sold
Expenses (other than auto): Advertising
Meals and entertainment
Bad debts
Insurance
Interest and bank charges
Business tax, fees, licences, dues, memberships & subscriptions
Office expenses
Office stationery and supplies
Legal, accounting & other professional fees
Management & administration fees
Rent
Maintenance & repairs
Salaries (including employer’s contributions)
Commissions paid, allowances, bonuses, etc
Property taxes
Moving expenses
Convention expenses
Light, heat & water
Telephone & utilities
Fuel costs (except for motor vehicles)
Deliver, freight & express
Other (please specify):
Private health services plan premiums:
Home office expenses: Total square footage of home (sq ft)
Total square feet used for home office (sq ft)
Heat ($)
Electricity
Insurance
Maintenance
Mortgage interest
Property taxes
Other (please specify)
Auto expenses: Total business km driven in 2022 * (km)
Total km driven in 2022 * (km)
Fuel (gasoline, propane, oil, electricity) ($)
Maintenance and repairs
Insurance
Licence and registration fees
Interest
Interest with respect to a motor vehicle other
than an automobile
Leasing costs
Other (please specify)
Reimbursements/rebates
Parking fees

Total Expense
Automobile lease:
Date lease commenced

MonthDayYear
Date
Mfg suggested retail price
Automobile purchase:
Purchase date

MonthDayYear
Date
Purchase price
GST incl. in price
*Note: CRA is now insisting on a mileage log or they will disallow all automobile expenses. Please ensure that you keep appropriate records of your mileage and base the km drive on the log book.
*Send lease and or purchase documents for the vehicle bought
How many internet webpages and websites does your business earn income from?

Provide the main webpage address (es) (also known as URL address (es)

	URL (https://)
1.
2.
3.
4.
5.

Percentage of gross income generated from the webpages and websites.

Acknowledgement & Signature
By signing below, you acknowledge and confirm that all information you entered here is true and correct and related to the tax year 2024 (January 1, 2024 to December 31, 2024). You also permit A&D Office Services Ltd. to capture and collect the information you entered in this form.
Date Signed*

MonthDayYear
Date
Signature*

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Date Signed

MonthDayYear
Date
Signature

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Should be Empty:

	Name	SIN	Date of Birth
Tax Payer
Spouse/Partner

	Address	Stay Duration
1
2
3
4

Personal Tax Intake Form

During 2024, did you:

Property details

Home office expenses:

Automobile lease:

Automobile purchase:

Reimbursements/Allowances:

Automobile lease:

Automobile purchase: