Questionnaire | McLean Bartok | Chartered Accounting

T1 Questionnaire

Please Complete all the fields in the following form:
First Name: *
Last Name: *
Dependant: (provide full name, birth date, social insurance number).
Dependant: (provide full name, birth date, social insurance number).
Dependant: (provide full name, birth date, social insurance number).
Dependant: (provide full name, birth date, social insurance number).
Has your Address Changed from 2009?	Yes No
New Address:
Email: *
Telephone: *
Preferred Contact Method:
Instead of a paper copy of my return, I want my tax return e-mailed to me in an encrypted PDF format.	Yes No
Are you a Canadian Citizen? A new question on the T1 Jacket.	Yes No
I Authorize Canada Revenue Agency to give (only) my name, address and date of birth to Elections Canada.	Yes No
At any time during calendar 2010, I had foreign assets (i.e. shares of foreign, including U.S, corporations, property, other investments), which cost more than $100,000 Cdn and therefore, I will have to report them on the Foreign Income Verification Statement (T1135E) and I will provide the details to you.	Yes No
Preferred Payment Method: If you plan to pay by credit card, you can provide credit card information over the phone or with the hard copy of your tax information.
Other Comments:
Signed:
Dated:
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