The information you enter here will be used strictly for us to return your message promptly and to serve you better. This information will not be shared with a third party.

You can fill in the on-line form below or print out the Client Information Checklist for Canadians, send it by mail, fax or bring it in person.

	Personal Information First Name: Last Name: Address: Phone Number: Email Address: Are you a Canadian citizen: Yes No Would you like us to provide your information to Elections Canada: Yes No Do you own foreign property valued at more than $100,000: Yes No Are you a GST/HST registrant: Yes No Marital status: Single Married Seperated Widowed Common Law Divorced Dependant Information Dependant 1 Full Name: Sex: Male Female Age: Dependant 2 Full Name: Sex: Male Female Age: Dependant 3 Full Name: Sex: Male Female Age: Dependant 4 Full Name: Sex: Male Female Age: Dependant 5 Full Name: Sex: Male Female Age: Please indicate if you receive any of the following source of income: Employment (T4, T4A, T4RSP, T4E): Yes No Retirement Benefits (T4OAS, T4AP T4RIF): Yes No Universal Child Care Benefit (RC62): Yes No Personal Business Income: Yes No Corporate Income: Yes No T5 and T3 (Interest on Investments): Yes No T5008 (Stock Investments): Yes No Rental Income: Yes No Foreign Income: Yes No Home Buyers Plan: Yes No Lifelong Learning Plan: Yes No Support Payments: Yes No Capital Gains: Yes No Please indicate if you have any of the following expenses: Business Expenses: Yes No Child Care : Yes No RRSP: Yes No T2202A (Tuition and Education): Yes No T2200 Employment Expenses: Yes No Transit Passes: Yes No Interest on Student Loans: Yes No Charitable Donations: Yes No Professional and/or Union Dues: Yes No Medical and Dental: Yes No Tax Installment Payments: Yes No Child Fitness: Yes No Please provide us with a copy of your previous years tax return if it was not prepared by us