Kristopher CRA 2019

®
H&R BLOCK
2019 return
for Kristopher Bailey
Thank you for using H&R Block Tax Software.
Downloaded on: 2021-12-20
Name: Kristopher Bailey

Tax year: 2019
CRA return - NETFILE confirmation number:819ROJ2BS30
Important: this copy of your return is for your records only. Don't send it to the CRA.
Protected B when completed
T1 Adjustment Request
• Use this form to request an adjustment (a change) to an individual income tax return. My Account allows you to change your return online more quickly.
You can get more information about My Account by going to canada.ca/my-cra-account.
• See the back of this form for information on how to complete this form.
• Send the completed form to the tax centre as indicated on the back of this form.
A Identification For filing Do not use this area

Social insurance number Adjustment request for the
2019 tax year
1 3 1 1 4 6 7 3 0 (complete a separate form for each year)
Space reserved for administrative purposes
Full name: (please print your surname first)
Address: (please print)

C
same as the return
Or: Acknowledgement Stall code
CRA User ID Date Rev. Date
L
B Authorization – Complete this area if the adjustment request is being made by an authorized individual.
AI
Name and address of authorized person or firm preparing this request: Letter of authorization (or Form T1013, Authorizing or Cancelling a
M
(please print) Representative) for the year under review (must indicate level 2—see
HOW TO COMPLETE THE FORM on reverse):
BY
was submitted previously
is attached
D
C Adjustment details
N
SE
List the details of your requested change below. If you have received an assessment or reassessment notice with an amount that is different from the amount
on the return you submitted, show the amount stated on the notice as the previous amount. You must provide supporting documentation for the entire revised
amount. This may include receipts, schedules, or other relevant documents. Your request may be delayed if you do not provide all required information
T
with this form. See the back of this form for information about required documentation and for examples of how to complete this area.
O
+
N
Line number from Name of line from return or schedule Previous amount Amount of change Revised amount
return or schedule –
O
D
E
AT
IC
PL
U
Other details or explanations (attach an extra sheet if required)

D
Why are you submitting this T1 Adjustment Request? Please check the most applicable (optional).
Taxpayer received The CRA’s published I did not know I could
Taxpayer received a slip late Other
an amended slip information was not clear make this claim
D Certification
I certify that the information given on this form and any documents attached is, to the best of my knowledge, correct and complete.
(Home)
(Business)
Date Taxpayer signature Representative signature Telephone
See the privacy notice on page 2.
T1-ADJ E (18) (Vous pouvez obtenir ce formulaire en français à canada.ca/arc-formulaires-publications ou au 1-800-959-3376.)

Privacy Notice
Personal information is collected under the Income Tax Act to administer tax, benefits, and related programs. It may also be used for any purpose related to the administration or
enforcement of the Act such as audit, compliance and the payment of debts owed to the Crown. It may be shared or verified with other federal, provincial/territorial government
institutions to the extent authorized by law. Failure to provide this information may result in interest payable, penalties or other actions. Personal information is described in Individual
Returns and Payment Processing CRA PPU 005 and is protected under the Privacy Act. Individuals have a right of protection, access to and correction or notation of their personal
information. Please be advised that you are entitled to complain to the Privacy Commissioner of Canada regarding our handling of your information.
How to complete the form

Area A: Identification
• Complete this area in full so that we know exactly who you are and what return you want us to reassess.
Note
We will accept a change of address only from you or your legal representative. A legal representative is an executor or
administrator of your estate, someone with a power of attorney or guardian. You can authorize your representative online using
the "Authorize my representative" service in My Account. For more information, go to canada.ca/my-cra-account or see
Form T1013.
Area B: Authorization
• Complete this area if you are authorizing a person or firm to make this request on your behalf.
• You have to authorize us to discuss your tax matters with this person or firm by providing a signed letter or Form T1013,
Authorizing or Cancelling a Representative. You do not have to provide a letter or Form T1013 if there is already one
on file.
• The letter of authorization or Form T1013 must indicate Level 2 to make changes to a taxpayer's account.
Note You can print form T1013 from our website at canada.ca/cra-forms-pubs.
Area C: Adjustment details
L
• Please provide all details for each change you request (you do not have to show a recalculation of your taxes).
AI
• Choose the appropriate plus/minus (+/–) indicator (for losses, e.g. self-employed business loss, chose minus "–").
M
• If you are changing a line on which you already claimed an amount (see Example 1, below) and you did not previously
provide the supporting documentation, you now have to provide supporting documentation for the entire revised amount.
BY
• Supporting documentation may include receipts, schedules, or other relevant documents. Your request may be delayed if
you do not provide all required information with this form.
D
• You can get more information about CRA's rules and policies for reassessments from our Web site at canada.ca/taxes or by
N
calling 1-800-959-8281.
SE
• Following is an example of how to complete this area.
Example
T
Mary filed her 2013 return reporting the following information:

O
Employment income $28,600

N
Union dues $500

After receiving her notice of assessment, Mary received an additional T4 slip. It showed $200 in income and $20 for union dues.
O
To request a change to her return, Mary will complete Area C as follows:

D
Line number from + Amount

E
Name of line from return or schedule Previous amount Revised amount

return or schedule – of change
AT
101 Employment income 28,600 + 200 28,800

212 Union dues 500 + 20 520
IC
Note
PL
Even though Mary did not submit receipts with her tax return for the original union dues claim of $500, she must now submit those
receipts along with her additional T4 slip.
U
D
Area D: Certification
• Make sure either you or your authorized representative signs and dates the request for a change to your return.
Send this form and any supporting documents, if applicable, to the tax centre that serves your area. Use the chart below to get the address.
If your tax services office is located in: Send your correspondence to the
following address:
Alberta, Manitoba, Northwest Territories, London, Saskatoon, Thunder Bay, Hamilton, Kitchener/Waterloo, Windsor, Winnipeg Tax Centre
British Columbia, Yukon, and Regina 66 Stapon Road
Winnipeg MB R3C 3M2
Toronto Centre, Toronto East, Toronto North, Toronto West, Barrie, Sudbury (the area of Sudbury/Nickel Belt only), Sudbury Tax Centre
Outaouais, Prince Edward Island, Belleville, Montréal, Ottawa, Sherbrooke, and Sudbury (other than the area of Post Office Box 20000, Station A
Sudbury/Nickel Belt), New Brunswick, Newfoundland and Labrador, Nova Scotia, Kingston, Peterborough, and Sudbury ON P3A 5C1
St. Catharines
Chicoutimi, Montérégie-Rive-Sud, Laval, Nunavut, Rouyn-Noranda, Québec, Rimouski, and Trois-Rivières Jonquière Tax Centre
2251 René-Lévesque Boulevard
Jonquière QC G7S 5J2
Deemed residents, non-residents, and new or returning residents of Canada Sudbury Tax Centre or
Winnipeg Tax Centre
Income Tax and Benefit Return 2019
Before you start:

If you are filling out this return for a deceased person, make sure you enter their information in all the boxes in Step 1.
Step 1 – Identification and other information

7
Identification Information about you
Print your name and address below. Enter your social
insurance number (SIN): 1 3 1 1 4 6 7 3 0
First name and initial Year Month Day
Kristopher 1 9 8 6 1 1 2 1
Enter your date of birth:
Last name
Bailey Your language of correspondence: English Français
Mailing address: Apt No. – Street No. Street name Votre langue de correspondance :
1-539 union
PO Box RR Is this return for a deceased person?
Ensure the SIN information above is for the deceased
L
City Prov./Terr. Postal code person.
AI
fredericton N B E 3 A 3 N 4 If this return is for a
M
deceased person, Year Month Day
Email address enter the date of death:
BY
By providing an email address, you are registering to receive Marital status
email notifications from the CRA and agree to the Terms of use Tick the box that applies to your marital status on
D
under Step 1 in the guide. December 31, 2019:
Enter an email address: kristophe8.6@gmail.com
N
SE
1 Married 2 Living common-law 3 Widowed
Information about your residence 4 Divorced 5 Separated 6 Single

T
O
Enter your province or territory of

residence on December 31, Information about your spouse or
N
2019: New Brunswick common-law partner (if you ticked box 1 or 2 above)
O
Enter the province or territory Enter their SIN:

D
where you currently reside if it is

not the same as your mailing
E
Enter their first name:

address above:
AT
Enter their net income for 2019

If you were self-employed in
IC
2019, enter the province or to claim certain credits:

territory where your business had Enter the amount of universal child
PL
a permanent establishment: care benefit (UCCB) from line 11700

of their return:
U
If you became or ceased to be a resident of Canada for Enter the amount of UCCB
D
income tax purposes in 2019, enter the date of: repayment from line 21300 of their
return:
Month Day Month Day
entry or departure Tick this box if they were self-employed in 2019: 1
Do not use this area
Do not use 17200 17100

this area
5000-R Page 1
Step 1 – Identification and other information (continued)
Please answer the following questions.
Elections Canada (For more information, see "Elections Canada" under Step 1, in the guide.)
A)Do you have Canadian citizenship? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes 1 No 2
If yes, go to question B. If no, skip question B.
B) As a Canadian citizen, do you authorize the Canada Revenue Agency to give your name, address,
date of birth, and citizenship to Elections Canada to update the National Register of Electors or, if
you are aged 14 to 17, to update the Register of Future Electors? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes 1 No 2
Your authorization is valid until you file your next tax return. Your information will only be used for purposes permitted under
the Canada Elections Act, which include sharing lists of electors produced from the National Register of Electors with
provincial and territorial electoral agencies, members of Parliament, registered and eligible political parties, and candidates
at election time.
Your information in the Register of Future Electors will be included in the National Register of Electors once you turn 18.
Information from the Register of Future Electors can be shared only with provincial and territorial electoral agencies that are
allowed to collect future elector information. In addition, Elections Canada can use information in the Register of Future
L
Electors to provide youth with educational information about the electoral process.
AI
M
BY
Indian Act – Exempt income
Tick this box if you have any income that is exempt under the Indian Act.
D
For more information on this type of income, go to canada.ca/taxes-aboriginal- 1
peoples.
N
SE
If you tick the box, get and complete Form T90, Income Exempt under the Indian Act. Complete this form so that the CRA
can calculate your Canada training credit limit for the 2020 tax year. The information you provide may also be used to
calculate your Canada workers benefit for the 2019 tax year, if applicable.
T
O
N
O
Foreign property
D
Did you own or hold specified foreign property where the total cost amount of all such
E
property, at any time in 2019, was more than CAN$100,000? . . . . . . . . . . . . . . . . . . . . . . 26600 Yes 1 No 2
AT
If yes, get and complete Form T1135, Foreign Income Verification Statement. There are substantial penalties for not
IC
completing and filing Form T1135 by the due date. For more information, see Form T1135.
PL
U
D
5000-R Page 2
Attach only the documents (schedules, information slips, forms, or receipts) requested to support
any claim or deduction. Keep all other supporting documents.
Step 2 – Total income

As a resident of Canada, you have to report your income from all sources both inside and outside Canada.
The Income Tax and Benefit Guide may have additional information for certain lines.
Employment income (box 14 of all T4 slips) 10100
Tax-exempt income for emergency services volunteers
(See line 10100 in the guide.) 10105
Commissions included on line 10100 (box 42 of all T4 slips) 10120
Wage-loss replacement contributions (See line 10100 in the guide.) 10130
Other employment income 10400 +
Old age security pension (box 18 of the T4A(OAS) slip) 11300 +
CPP or QPP benefits (box 20 of the T4A(P) slip) 11400 +
Disability benefits included on line 11400 (box 16 of the T4A(P) slip) 11410
Other pensions and superannuation
(See line 11500 in the guide and complete line 31400 in the Worksheet for the return.) 11500 +
L
AI
Elected split-pension amount (Get and complete Form T1032.) 11600 +
M
Universal child care benefit (UCCB) (See the RC62 slip.) 11700 +
UCCB amount designated to a dependant 11701
BY
Employment insurance and other benefits (box 14 of the T4E slip) 11900 +
Employment insurance maternity and parental benefits and provincial
D
parental insurance plan benefits 11905
N
Taxable amount of dividends (eligible and other than eligible) from taxable Canadian corporations
SE
(Complete the Worksheet for the return.) 12000 +
Taxable amount of dividends other than eligible dividends, included on
T
line 12000, from taxable Canadian corporations 12010

O
Interest and other investment income (Complete the Worksheet for the return.)
N
12100 +
Net partnership income: limited or non-active partners only 12200 +
O
Registered disability savings plan income (box 131 of the T4A slip) 12500 +
D
Rental income Gross 12599 Net 12600 +

E
Taxable capital gains (Complete Schedule 3.) 12700 +

AT
Support payments received Total 12799 Taxable amount 12800 +

IC
RRSP income (from all T4RSP slips) 12900 +

PL
Other income Specify: 13000 +

Taxable scholarship, fellowships, bursaries, and artists' project grants 13010 +
U
Self-employment income
D
Business income Gross 13499 Net 13500 +

Professional income Gross 13699 Net 13700 +
Commission income Gross 13899 Net 13900 +
Farming income Gross 14099 Net 14100 +
Fishing income Gross 14299 Net 14300 +
Workers' compensation benefits (box 10 of the T5007 slip) 14400
Social assistance payments 14500 +
Net federal supplements (box 21 of the T4A(OAS) slip) 14600 +
◄
Add lines 14400, 14500, and 14600. (See line 25000 in Step 4.) = 14700 +
Add lines 10100, 10400 to 11400, 11500 to 11700, 11900, 12000,
12100 to 12500, 12600, 12700, 12800, 12900 to 13010, 13500, 13700,
13900, 14100, 14300, and 14700. This is your total income. 15000 = 0.00
5000-R Page 3
Step 3 – Net income
Enter your total income from line 15000 from the previous page. 15000 0.00
Pension adjustment (box 52 of all T4 slips and
box 034 of all T4A slips) 20600
Registered pension plan deduction
(box 20 of all T4 slips and box 032 of all T4A slips) 20700
RRSP deduction (See Schedule 7 and attach receipts.) 20800 +
Pooled registered pension plan (PRPP)
employer contributions (amount from your
PRPP contribution receipts) 20810
Deduction for elected split-pension amount (Get and complete Form T1032.) 21000 +
Annual union, professional, or like dues (receipts and box 44 of all T4 slips) 21200 +
Universal child care benefit repayment (box 12 of all RC62 slips) 21300 +
Child care expenses (Get and complete Form T778.) 21400 +
Disability supports deduction (Get and complete Form T929.) 21500 +
Business investment loss Gross 21699 Allowable deduction 21700 +
Moving expenses (Get and complete Form T1-M.) 21900 +
L
Support payments made Total 21999 Allowable deduction 22000 +
AI
Carrying charges and interest expenses
M
(Complete the Worksheet for the return.) 22100 +
BY
Deduction for CPP or QPP contributions on self-employment and other
earnings (Complete Schedule 8 or get and complete Form RC381,
whichever applies.) 22200 + •
D
Deduction for CPP or QPP enhanced contributions on employment income
N
(Complete Schedule 8 or get and complete Form RC381, whichever applies.) 22215 + •
SE
Exploration and development expenses (Get and complete Form T1229.) 22400 +
Other employment expenses 22900 +
T
O
Clergy residence deduction (Get and complete Form T1223.) 23100 +

N
Other deductions Specify: 23200 +

O
Add lines 20700, 20800, 21000 to 21500, 21700, 21900, 22000, and
◄
22100 to 23200. 23300 = –
D
Line 15000 minus line 23300 (if negative, enter "0") This is your net income before adjustments. 23400 =
E
Social benefits repayment (If you reported income at line 11900 and the amount at line 23400 is
AT
greater than $66,375, see the repayment chart on the back of your T4E slip. If you reported income
on lines 11300 or 14600, and the amount at line 23400 is greater than $77,580, complete the chart
IC
for line 23500 on the Worksheet for the return. Otherwise, enter "0".) 23500 – •
PL
Line 23400 minus line 23500 (if negative, enter "0") This is your net income. 23600 = 0.00
U
D
5000-R Page 4
Step 4 – Taxable income

Canadian Forces personnel and police deduction (box 43 of all T4 slips) 24400
Security options deductions 24900 +
Other payments deduction (Claim the amount from line 14700, unless it
includes an amount at line 14600. If so, see line 25000 in the guide.) 25000 +
Limited partnership losses of other years 25100 +
Non-capital losses of other years 25200 +
Net capital losses of other years 25300 +
Capital gains deduction (Get and complete Form T657.) 25400 +
Northern residents deductions (Get and complete Form T2222.) 25500 +
Additional deductions Specify: 25600 +
◄
Add lines 24400 to 25600. 25700 = –
Line 23600 minus line 25700 (if negative, enter "0") This is your taxable income. 26000 = 0.00
L
AI
M
BY
D
N
SE
T
O
N
O
D
E
AT
IC
PL
U
D
5000-R Page 5
Step 5 – Federal tax (formerly Schedule 1)
Part A – Federal non-refundable tax credits
Basic personal amount claim $12,069 30000 12,069.00 1
Age amount (if you were born in 1954 or earlier)
(Complete the Worksheet for the return.) (maximum $7,494) 30100 + 2
Spouse or common-law partner amount (Complete Schedule 5.) 30300 + 3
Amount for an eligible dependant (Complete Schedule 5.) 30400 + 4
Canada caregiver amount for spouse or common-law partner, or eligible dependant
age 18 or older (Complete Schedule 5.) 30425 + 5
Canada caregiver amount for other infirm dependants age 18 or older (Complete Schedule 5.) 30450 + 6
Canada caregiver amount for infirm children under 18 years of age
Enter the number of children for whom you are claiming this amount. 30499 × $ 2,230 = 30500 + 7
Base CPP or QPP contributions:
through employment income
(Complete Schedule 8 or get and complete Form RC381, whichever applies.) 30800 + • 8
on self-employment and other earnings
(Complete Schedule 8 or get and complete Form RC381, whichever applies.) 31000 + • 9
L
Employment insurance premiums:
AI
through employment from box 18 and box 55 of all T4 slips (maximum $860.22) 31200 + • 10
M
on self-employment and other eligible earnings (Complete Schedule 13.) 31217 + • 11
Volunteer firefighters' amount +
BY
31220 12
Search and rescue volunteers' amount 31240 + 13
D
Canada employment amount (Enter $1,222 or the total of your employment income you reported
on lines 10100 and 10400, whichever is less.)
N
31260 + 14
SE
Home buyers' amount 31270 + 15
Home accessibility expenses (Complete the Worksheet for the return.) (maximum $10,000) 31285 + 16
T
Adoption expenses 31300 + 17

O
Pension income amount (Complete the Worksheet for the return.) (maximum $2,000) 31400 + 18
N
Disability amount (for self)

O
(Claim $8,416 or if you were under 18 years of age, complete the Worksheet for the return.) 31600 + 19
D
Disability amount transferred from a dependant (Complete the Worksheet for the return.) 31800 + 20
E
Interest paid on your student loans (See Guide P105.) 31900 + 21

AT
Your tuition, education, and textbook amounts (Complete Schedule 11.) 32300 + 22
Tuition amount transferred from a child 32400 + 23
IC
Amounts transferred from your spouse or common-law partner (Complete Schedule 2.) 32600 + 24
PL
Medical expenses for self, spouse or common-law partner, and

U
your dependent children born in 2002 or later 33099 25

D
Enter $2,352 or 3% of line 23600, whichever is less. – 26

Line 25 minus line 26 (if negative, enter "0") = 27
Allowable amount of medical expenses for other dependants
(Complete the Worksheet for the return.) 33199 + 28
Add lines 27 and 28. =
◄
33200 + 29
Add lines 1 to 24, and line 29. 33500 = 12,069.00 30
Federal non-refundable tax credit rate × 15% 31
Multiply line 30 by line 31. 33800 = 1,810.35 32
Donations and gifts (Complete Schedule 9.) 34900 + 33
Add lines 32 and 33.
Enter this amount on line 46 on the next page. Total federal non-refundable tax credits 35000 = 1,810.35 34
5000-R Page 6
Part B – Federal tax on taxable income
Enter your taxable income from line 26000. 0.00 35
Complete the
appropriate column Line 35 is more Line 35 is more Line 35 is more
depending on the Line 35 is than $47,630 but than $95,259 but than $147,667 but Line 35 is more
amount on line 35. $47,630 or less not more than not more than not more than than $210,371
Enter the amount $95,259 $147,667 $210,371
from line 35. 36
Line 36 minus line 37 – 0.00 – 47,630.00 – 95,259.00 – 147,667.00 – 210,371.00 37
(cannot be negative) = = = = = 38
Multiply line 38 × 15% × 20.5% × 26% × 29% × 33% 39
by line 39. = = = = = 40
+ 0.00 + 7,145.00 + 16,908.00 + 30,535.00 + 48,719.00 41
Add lines 40 and 41. = = = = = 42
Part C – Net federal tax

Enter the amount from line 42. 43
L
Federal tax on split income (Get and complete Form T1206.) 40424 + • 44
AI
Add lines 43 and 44. 40400 =
◄
45
M
Enter your total federal non-refundable tax credits
BY
from line 34 on the previous page. 35000 1,810.35 46
Federal dividend tax credit (See line 40425 in the guide.) 40425 + • 47
D
Minimum tax carryover (Get and complete Form T691.) 40427 + • 48
Add lines 46, 47, and 48.
N = 1,810.35 – 1,810.35 49
◄
SE
Line 45 minus line 49 (if negative, enter "0") Basic federal tax 42900 = 0.00 50
Federal foreign tax credit (Get and complete Form T2209.) 40500 – 51
T
Line 50 minus line 51 (if negative, enter "0") Federal tax 40600 = 0.00 52
O
N
Total federal political contributions

(attach receipts) 40900 53
O
Federal political contribution tax credit

D
(Complete the Worksheet for the return.) (maximum $650) 41000 • 54

E
Investment tax credit (Get and complete Form T2038(IND).) 41200 + • 55

AT
Labour-sponsored funds tax credit

(See lines 41300 and 41400 in the guide.)
IC
Net cost of shares of a

PL
provincially registered fund 41300 Allowable credit 41400 + • 56

◄
U
Add lines 54, 55, and 56. 41600 = – 57

D
Line 52 minus line 57 (if negative, enter "0") 41700 = 58

Canada workers benefit advance payments received
(box 10 of the RC210 slip) 41500 + • 59
Special taxes (See line 41800 in the guide.) 41800 + 60
Add lines 58, 59, and 60.
Enter this amount on line 42000 on the next page. Net federal tax 42000 = 0.00 61
Step 6 – Provincial or territorial tax

Complete Form 428 to calculate your provincial tax.
5000-R Page 7
Step 7 – Refund or balance owing
Net federal tax: enter the amount from line 61 from the previous page. 42000
CPP contributions payable on self-employment and other earnings
(Complete Schedule 8 or get and complete Form RC381, whichever applies.) 42100 +
Employment insurance premiums payable on self-employment and other eligible earnings
(Complete Schedule 13.) 42120 +
Social benefits repayment (amount from line 23500) 42200 +
Provincial or territorial tax (Attach Form 428, even if the result is "0".) 42800 +
Add lines 42000, 42100, 42120, 42200, and 42800. This is your total payable. 43500 = •
Total income tax deducted (amounts from all Canadian slips) 43700 •
Refundable Quebec abatement (See line 44000 in the guide.) 44000 + •
CPP overpayment (See line 30800 in the guide.) 44800 + •
Employment insurance overpayment (See line 45000 in the guide.) 45000 + •
Refundable medical expense supplement
(Complete the Worksheet for the return.) 45200 + •
Canada workers benefit (CWB) (Complete Schedule 6.) 45300 + •
Refund of investment tax credit (Get and complete Form T2038(IND).) 45400 + •
L
Part XII.2 trust tax credit (box 38 of all T3 slips and box 209 of all T5013 slips) 45600
AI
+ •
Employee and partner GST/HST rebate (Get and complete Form GST370.) 45700 + •
M
Eligible educator school supply tax credit
BY
Supplies expenses (maximum $1,000) 46800 × 15% = 46900 + •
Tax paid by instalments 47600 + •
D
Provincial or territorial credits (Complete Form 479, if it applies.) 47900 + •
N
SE
Add lines 43700 to 45700, and 46900 ◄
to 47900. These are your total credits. 48200 = –
T
Line 43500 minus line 48200 This is your refund or balance owing. =
O
N
If the result is negative, you have a refund. If the result is positive, you have a balance owing.
O
Enter the amount below on whichever line applies.

D
Generally, we do not charge or refund a difference of $2 or less.

E
◄
◄
AT
Refund 48400 • Balance owing 48500 0.00 •

IC
◄
◄
For more information on how to receive your refund For more information on how to make your payment, see
PL
by direct deposit, see line 48400 in the guide or go line 48500 in the guide or go to canada.ca/payments.
to canada.ca/cra-direct-deposit. Your payment is due no later than April 30, 2020.
U
D
I certify that the information given on this return and in any If this return was completed by a tax professional, tick the
documents attached is correct and complete and fully discloses applicable box and provide the following information:
all my income.
49000 Was a fee charged? Yes 1 No 2
Sign here
48900 EFILE number (if applicable):
It is a serious offence to make a false return.
Name of tax professional:
Telephone number:
Telephone number:
Date:
Personal information (including the SIN) is collected for the purposes of the administration or enforcement of the Income Tax Act and related programs and
activities including administering tax, benefits, audit, compliance, and collection. The information collected may be used or disclosed for purposes of other
federal acts that provide for the imposition and collection of a tax or duty. It may also be disclosed to other federal, provincial, territorial or foreign government
institutions to the extent authorized by law. Failure to provide this information may result in interest payable, penalties or other actions. Under the Privacy Act,
individuals have the right to access their personal information, request correction, or file a complaint to the Privacy Commissioner of Canada regarding the
handling of the individual’s personal information. Refer to Personal Information Bank CRA PPU 005 on Info Source at canada.ca/cra-info-source.
Do not use • 48600 •

48700 48800
this area
5000-R Page 8
Kristopher Bailey 131146730
Form NB428
New Brunswick Tax and Credits 2019
This is Step 6 in completing your return. Complete this form and attach a copy to your return.
Claim only the credits that apply to you.
Part A – New Brunswick non-refundable tax credits

For internal use only 56030
Basic personal amount Claim $10,264 58040 10,264.00 1
Age amount (if born in 1954 or earlier)
(use Worksheet NB428) (maximum $5,012) 58080 + 2
Spouse or common-law partner amount
Base amount 9,588.00 3
Your spouse's or common-law partner's
net income from line 23600 of their return – 4
Ż
Line 3 minus line 4 (if negative, enter "0") = 0.00 (maximum $8,716) 58120 + 0.00 5
Amount for an eligible dependant
L
AI
Your eligible dependant's net income
from line 23600 of their return – 7
M
Ż
Line 6 minus line 7 (if negative, enter "0") = 0.00 (maximum $8,716) 58160 + 0.00 8
BY
Add lines 1, 2, 5, and 8 = 10,264.00 9
Amount for infirm dependants age 18 or older
D
(use Worksheet NB428) 58200 + 10
CPP or QPP contributions:
N
SE
Amount from line 30800 of your return 58240 + • 11
T
Employment insurance premiums:

O

N

O
Pension income amount (maximum $1,000) 58360 + 15

D
Caregiver amount
E

AT
Disability amount (for self)

(Claim $8,310, or if you were under 18 years of age, use Worksheet NB428.) 58440 + 17
IC
Disability amount transferred from a dependant

PL

U
Interest paid on your student loans

(amount from line 31900 of your return)
D
58520 + 19
Your tuition and education amounts
(attach Schedule NB(S11)) 58560 + 20
Tuition amounts transferred from a child 58600 + 21
Amounts transferred from your spouse or common-law partner
(attach Schedule NB(S2)) 58640 + 22
Add lines 9 to 22. = 10,264.00 23
Continue on the next page.
5004-C (Ce formulaire est disponible en français.)

Part A – New Brunswick non-refundable tax credits (continued)
Amount from line 23 on the previous page 10,264.00 24
Medical expenses:
Amount from line 33099 of your return 58689 25
Enter whichever is less:
$2,323 or 3% of line 23600 of your return. – 26
Line 25 minus line 26 (if negative, enter "0") = 0.00 27
Allowable amount of medical expenses for other dependants
Ż
Add lines 27 and 28. 58769 = + 29
Add lines 24 and 29. 58800 = 10,264.00 30
New Brunswick non-refundable tax credit rate × 9.68% 31
Multiply line 30 by line 31. 58840 = 993.56 32
Donations and gifts:
Amount from line 16
of your federal Schedule 9 × 9.68% = 33
Amount from line 17
L
of your federal Schedule 9 × 17.95% = + 34
AI
Ż
Add lines 33 and 34. 58969 = + 35
M
BY
Add lines 32 and 35. New Brunswick non-refundable tax credits 61500 = 993.56 36
D
Part B – New Brunswick tax on taxable income
N
SE
Enter your taxable income from line 26000 of your return. 37
Use the amount on line 37 to decide which column to complete.
T
O
Line 37 is more Line 37 is more Line 37 is more

than $138,491
N
than $42,592 than $85,184

Line 37 is but not more but not more but not more Line 37 is more
than $157,778
O
$42,592 or less than $85,184 than $138,491 than $157,778

Amount from line 37 38
D
Line 38 minus line 39 – 0.00 – 42,592.00 – 85,184.00 – 138,491.00 – 157,778.00 39

E
(cannot be negative) = = = = = 40
AT
× 9.68% × 14.82% × 16.52% × 17.84% × 20.30% 41

Multiply line 40 by line 41. = = = = = 42
IC
Add lines 42 and 43. + 0.00 + 4,123.00 + 10,435.00 + 19,241.00 + 22,682.00 43

PL
New Brunswick tax

on taxable income = = = = = 44
U
D
Part C – New Brunswick tax

Enter your New Brunswick tax on taxable income from line 44. 45
Enter your New Brunswick tax on split income from Form T1206. 61510 + • 46
Add lines 45 and 46. = 47
Enter your New Brunswick non-refundable tax credits from line 36. – 993.56 48
5004-C
Part C – New Brunswick tax (continued)
Amount from line 49 on the previous page 50
New Brunswick dividend tax credit

Credit calculated for line 61520 on Worksheet NB428 61520 • 51
New Brunswick minimum tax carryover
Amount from line 40427 of your return × 57% = 61540 + • 52
Ż
Add lines 51 and 52. = – 53
New Brunswick additional tax for minimum tax purposes
Form T691: line 111 minus line 114 × 57% = + 55
Enter the provincial foreign tax credit from Form T2036. – 57
Line 56 minus line 57 (if negative, enter "0"). = 0.00 58
New Brunswick low-income tax reduction
If you had a spouse or common-law partner on December 31, 2019, you and your spouse or
common-law partner need to decide who will claim this tax reduction for your family. Any unused
amount from line 81 can be claimed by the other spouse or common-law partner on line 59 of their
L
AI
Form NB428.
M
Unused low-income tax reduction from your spouse or common-law partner
Amount from line 81 of your spouse's or common-law partner's Form NB428, if any 61560 – • 59
BY
Line 58 minus line 59 (if negative, enter "0")
Enter this amount on line 67 on the next page. = 0.00 60
D
If you are claiming an amount on line 59 (other than "0"), enter the amount from line 60 on line 78
and continue on line 82. If not, continue on line 61.
N
SE
You are eligible to claim the low-income tax reduction if either of the following applies:
T
• You are single and your net income from line 23600 of your return is less than $39,297.
O
• You have an eligible dependant, or spouse or common-law partner, and your adjusted family
N
income (calculated using the chart below) is less than $61,463.

O
If neither of these conditions applies to you, enter "0" on line 77, enter the amount from line 67
D
on line 78, and continue on line 82.

E
Column 1 Column 2
AT
Adjusted family income for the calculation

For you For your spouse or
of the New Brunswick low-income tax reduction common-law partner
IC
Net income from line 23600 of the return 61 61

PL
Total of the universal child care benefit (UCCB) repayment (line 21300
U
of the return) and the registered disability savings plan (RDSP) income
repayment (included on line 23200 of the return)
D
+ 62 + 62
Add lines 61 and 62. = 63 = 63
Total of the UCCB income (line 11700 of the return) and the RDSP
income (line 12500 of the return) – 64 – 64
Line 63 minus line 64 (if negative, enter "0") = 0.00 65 = 0.00 65
Add the amounts on line 65 in columns 1 and 2.
Enter the result on line 72 on the next page. Adjusted family income 66
5004-C
Kristopher Bailey 131146730 Protected B when completed
Part C – New Brunswick tax (continued)
Basic reduction Claim $665 61570 665.00 68
Reduction for your spouse or common-law partner Claim $665 61580 + 69
Reduction for an eligible dependant claimed
on line 30400 of your return Claim $665 61590 + 70
Add lines 68 to 70. (maximum $1,330) = 665.00 71
Adjusted family income

Base amount – 17,130.00 73
Applicable rate × 3% 75
Ż
Multiply line 74 by line 75. = – 76
Line 71 minus line 76
Ż
(if negative, enter "0") New Brunswick low-income tax reduction = 665.00 – 665.00 77
L
AI
Unused low-income tax reduction that your spouse or common-law partner can claim
M
Amount from line 77 above 665.00 79
BY
Amount from line 58 on the previous page – 80
Line 79 minus line 80 (if negative, enter "0") Unused amount = 665.00 81
D
Political contribution tax credit
N
SE
New Brunswick political contributions made in 2019 61550 82
Credit calculated for line 83 on Worksheet NB428 (maximum $500) – 83
T

O
N
Labour-sponsored venture capital fund tax credit

Enter the credit amount from NB-LSVC-1 certificate(s). (maximum $2,000) 61670 – •85
O

D
E
Small business investor tax credit

AT
Enter the credit amount from Form T1258. – 87

IC
Enter the result on line 42800 of your return. New Brunswick tax = 0.00 88
PL
See the privacy notice on your return.

U
D
5004-C
2019
Worksheet NB428
Use this worksheet to calculate the amounts to enter on Form NB428, New Brunswick Tax and Credits.
Keep this worksheet for your records. Do not attach it to your return.
Line 58080 – Age amount (if born in 1954 or earlier)

If the amount from line 23600 of your return is:
• $37,311 or less, enter $5,012 on line 58080 of your Form NB428
• more than $37,311 but not more than $70,725, complete the calculation below
• more than $70,725, enter "0" on line 58080 of your Form NB428
Maximum amount 5,012.00 1

Amount from line 23600 of your return 2
Income threshold – 37,311.00 3
Applicable rate × 15% 5
Ż
Multiply line 4 by line 5. = – 6
L
Line 1 minus line 6 (if negative, enter "0") =
AI
7
Enter this amount on line 58080 of your Form NB428.
M
BY
Line 58200 – Amount for infirm dependants age 18 or older
Complete one column for each dependant. If you have more than three dependants, use a separate sheet of paper.
D
Dependant 1
N Dependant 2 Dependant 3
SE
Base amount 11,725.00 1 11,725.00 1 11,725.00 1
Dependant's net income from line 23600
T
of their return – 2 – 2 – 2
O

N
(maximum $4,847 per dependant) = 3 = 3 = 3

O
Amount claimed for this dependant on line 58160

D
of your Form NB428, if any – 4 – 4 – 4

E
Allowable amount for this dependant:

AT
line 3 minus line 4 (if negative, enter "0") = 5 = 5 = 5

Add the amounts from line 5 for columns 1, 2, and 3 (and others, if any). 6
IC
Enter the total on line 58200 of your Form NB428.

PL
U
Line 58400 – Caregiver amount

D
Dependant 1 Dependant 2 Dependant 3
Base amount 21,402.00 1 21,402.00 1 21,402.00 1
Dependant's net income from line 23600 of their return – 2 – 2 – 2
(maximum $4,848 per dependant) = 3 = 3 = 3
Amount claimed for this dependant on line 58160
of your Form NB428, if any – 4 – 4 – 4
line 3 minus line 4 (if negative, enter "0") = 5 = 5 = 5
5004-D (Ce formulaire est disponible en français.)

Worksheet NB428 (continued)
Line 58440 – Disability amount (for self)
Complete this calculation if you were under 18 years of age on December 31, 2019:
Total child care and attendant care expenses for you
claimed by you or another person 3
Threshold for child and attendant care expenses – 2,839.00 4
Ż
Line 3 minus line 4 (if negative, enter "0") = – 5
Ż
Line 2 minus line 5 (if negative, enter "0") = + 6
Add lines 1 and 6. (maximum $13,158) = 7
Line 58480 – Disability amount transferred from a dependant

Complete this calculation for each dependant. If you have more than one dependant, use a separate sheet of paper.
L
Note: If you and your dependant were not residents of the same province or territory at the end of the year, special rules may
AI
apply. Contact the Canada Revenue Agency to find out how much you can claim.
M
BY
If the dependant was under 18 years of age on December 31, 2019, complete lines 2 to 12.
If the dependant was 18 years of age or older, enter "0" on line 6 and continue on line 7.
D
Total child care and attendant care expenses for this N
SE
dependant claimed by you or another person 3
Threshold for child and attendant care expenses – 4
T
Ż
Line 3 minus line 4 (if negative, enter "0") = –
O
5
Line 2 minus line 5 (if negative, enter "0") Ż
N
= + 6
Add lines 1 and 6. (maximum $13,158) = 7
O
Total of amounts your dependant can claim on lines 9 to 16 of their Form NB428 +
D
8
E
Dependant's taxable income from line 26000 of their return

AT
– 10
IC

PL
Amount from line 7 or line 11, whichever is less 12

Enter on line 58480 of your Form NB428 the total of allowable amounts claimed for all dependants.
U
D
5004-D
Worksheet NB428 (continued)
Line 58729 – Allowable amount of medical expenses for other dependants

Dependant 1 Dependant 2 Dependant 3
Medical expenses for other dependant 1 1 1
Enter whichever is less:
$2,323 or 3% of the dependant's net income
from line 23600 of their return – 2 – 2 – 2
Line 1 minus line 2 (if negative, enter "0") = 3 = 3 = 3
Line 61520 – New Brunswick dividend tax credit

Calculate the amount to enter on line 61520 of your Form NB428 by completing one of the following calculations:
• If you entered an amount on line 12000 of your return but no amount on line 12010:
L
Amount from line 12000 of your return × 14% =
AI
M
• If you entered an amount on lines 12000 and 12010 of your return:
BY
Amount from line 12000 of your return 1
D
Amount from line 12010 of your return – 2 × 2.75% = 3
Line 1 minus line 2 =
N 4 × 14% = + 5
SE
T
O
N
Line 83 – New Brunswick political contribution tax credit

O
If your total political contributions from line 82 of Form NB428 are more than $1,075, enter $500 on line 83 of your
D
Form NB428. If not, use the amount from line 82 to decide which column to complete.
E
Line 82 is more
than $200 but
AT
Line 82 is not more Line 82 is

$200 or less than $550 more than $550
IC
Enter your total contributions from line 82 of your

Form NB428.
PL
1
– 0.00 – 200.00 – 550.00 2
U
Line 1 minus line 2 (cannot be negative) = 0.00 = = 3

D
× 75% × 50% × 33.33% 4

Multiply line 3 by line 4. = = = 5
+ 0.00 + 150.00 + 325.00 6
Add lines 5 and 6. = = = 7
5004-D

Kristopher CRA 2019

Uploaded by

Copyright:

Available Formats

You might also like

Kristopher CRA 2019

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Kristopher CRA 2019

Uploaded by

Copyright:

Available Formats

®

Name: Kristopher Bailey

A Identification For filing Do not use this area

Address: (please print)

CRA User ID Date Rev. Date

Other details or explanations (attach an extra sheet if required)

See the privacy notice on page 2.

T1-ADJ E (18) (Vous pouvez obtenir ce formulaire en français à canada.ca/arc-formulaires-publications ou au 1-800-959-3376.)

How to complete the form

Mary filed her 2013 return reporting the following information:

Employment income $28,600

Union dues $500

To request a change to her return, Mary will complete Area C as follows:

Line number from + Amount

Name of line from return or schedule Previous amount Revised amount

101 Employment income 28,600 + 200 28,800

Income Tax and Benefit Return 2019

Before you start:

Step 1 – Identification and other information

Information about your residence 4 Divorced 5 Separated 6 Single

Enter your province or territory of

Enter the province or territory Enter their SIN:

where you currently reside if it is

Enter their first name:

Enter their net income for 2019

2019, enter the province or to claim certain credits:

a permanent establishment: care benefit (UCCB) from line 11700

Do not use this area

Do not use 17200 17100

Step 2 – Total income

line 12000, from taxable Canadian corporations 12010

Rental income Gross 12599 Net 12600 +

Taxable capital gains (Complete Schedule 3.) 12700 +

Support payments received Total 12799 Taxable amount 12800 +

RRSP income (from all T4RSP slips) 12900 +

Other income Specify: 13000 +

Business income Gross 13499 Net 13500 +

Clergy residence deduction (Get and complete Form T1223.) 23100 +

Other deductions Specify: 23200 +

Step 4 – Taxable income

Adoption expenses 31300 + 17

Disability amount (for self)

Interest paid on your student loans (See Guide P105.) 31900 + 21

Medical expenses for self, spouse or common-law partner, and

your dependent children born in 2002 or later 33099 25

Enter $2,352 or 3% of line 23600, whichever is less. – 26

Add lines 40 and 41. = = = = = 42

Part C – Net federal tax

Total federal political contributions

Federal political contribution tax credit

(Complete the Worksheet for the return.) (maximum $650) 41000 • 54

Investment tax credit (Get and complete Form T2038(IND).) 41200 + • 55

Labour-sponsored funds tax credit

Net cost of shares of a

provincially registered fund 41300 Allowable credit 41400 + • 56

Add lines 54, 55, and 56. 41600 = – 57

Line 52 minus line 57 (if negative, enter "0") 41700 = 58

Step 6 – Provincial or territorial tax