PERSONAL TAX INFORMATION FORM

BASIC INFORMATION

YOU YOUR SPOUSE       FIRST NAME INDICATE YOUR MARITAL STATUS MARRIED LAST NAME   SINGLE SIN #   COMMON LAW DATE OF BIRTH   SEPERATED EMAIL ADDRESS   DIVORCED HOME PHONE   WIDOWED

DEPENDENTS INFORMATION

NAME AGE SIN RELATIONSHIP DATE OF BIRTH MEDICAL EXPENSES AMOUNT PAID BY YOU AMOUNT PAID BY YOUR SPOUSE AMOUNT PAID FOR DEPENDENTS AMOUNT PAID FOR DEPENDENTS Health Insurance and Dentist Prescription drugs

CONTRIBUTIONS CHILD CARE EXPENSES   YOU (AMOUNT PAID) YOUR SPOUSE (AMOUNT PAID)   AMOUNT PAID Charity's   NAME OF PROVIDER Church and Other   ADDRESS OF PROVIDER

TAXES AND ONTARIO CREDITS

TAX NAME AMOUNT PAID ADDRESS MUNICIPALITY # OF MONTHS Property Tax Paid   AMOUNT PAID ADDRESS PAID TO # OF MONTHS Rent Paid

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