ProTax Canada Inc.Unit 11, 800 Queenston Road, Hamilton, ON L8G 1A7
905-930-7410 · protaxcanada@hotmail.ca
Monday – Friday 10:00 AM – 6:00 PM

Tax return drop-off form

Fill this in and bring it with your documents. It tells us who you are, what you've enclosed, and what to look out for on your return.

1 · Your details

First nameLast nameSocial Insurance NumberDate of birth (DD / MM / YYYY)PhoneEmail

Home address (street, city, province, postal code)

Marital status on 31 DecemberDid your address change this year? (Y / N)

2 · Spouse or partner (if we are filing together)

First nameLast nameSocial Insurance NumberDate of birth (DD / MM / YYYY)Net income for the yearFiling with us as well? (Y / N)

3 · Dependants

One line per child or dependant.

Name / date of birth / SINName / date of birth / SINName / date of birth / SIN

4 · What's enclosed

T4 — employment
T4A — pension, self-employed commissions
T4A(P) / T4A(OAS) — CPP / OAS
T4E — EI
T5 — investment income
T3 — trust income
T5007 — social assistance / WSIB
T4RSP / T4RIF — RRSP / RRIF
RRSP contribution receipts
T2202 — tuition
Medical receipts
Charitable donation receipts
Childcare receipts
Rent or property tax paid
T2200 — employment expenses
Rental income and expenses
Self-employment income and expenses
Last year's Notice of Assessment

Anything else enclosed

5 · Anything we should know

6 · Authorisation

I confirm the documents and information provided are complete and accurate to the best of my knowledge, and I authorise ProTax Canada Inc. to prepare and eFile my return. My final fee will be confirmed from these documents before filing. All fees are plus HST.

SignatureDate

Office use only

Received byDate receivedQuoted feeReady / contacted