NR4 Statement of Amounts Paid or Credited to Non-Residents of Canada

2017V1 - updated 2016-10-27

<Return>

<NR4>

<NR4Slip>
Note: When completing the NR4 return, include either the Corporation Information or the Recipient Information, NOT both.

<ENTPRS_NM>

<l1_nm></l1_nm>
Corporation, organization, association, trust, or institution recipient name - line 1
-Required 35 alphanumeric
- First line of the recipient corporation, organization, association, trust, or institution's name
- if “&” is used in the name area enter as “&”

<l2_nm></l2_nm>
Corporation, organization, association, trust, or institution recipient name - line 2
- 35 alphanumeric
- Second line of the recipient corporation, organization, association, trust, or institution's name
- if “&” is used in the name area enter as “&”

</ENTPRS_NM>

<RCPNT_NM>

<snm></snm>
Individual recipient surname
- Required 20 alphanumeric
- First 20 letters of the recipient's surname
- Omit titles such as Mr., Mrs., etc.
- Do not include first name or initials

<gvn_nm></gvn_nm>
Individual recipient first name
- 12 alphanumeric
- First 12 letters of the recipient's first given name
Note: If only initials are available, provide the recipient's first initial.

<init></init>
Individual recipient initial
- 1 alphanumeric
- Initial of the recipient's second given name

</RCPNT_NM>

<SEC_RCPNT_NM>
Note: Complete this section only if the first recipient surname is already completed.

<sec_snm></sec_snm>
Second individual recipient surname
- 20 alphanumeric
- If a second recipient's name appears on the NR4 slip, the first 20 letters of the second recipient's surname
- Omit titles such as Mr., Mrs., etc.
- Do not include first name or initials.

<sec_gvn_nm></sec_gvn_nm>
Second individual recipient first name
- 12 alphanumeric
- If a second recipient's name appears on the NR4 slip, the first 12 letters of the second recipient's first given name
Note: If only initials are available, provide the recipient's first initial.

<sec_init></sec_init>
Second individual recipient initial
- 1 alphanumeric
- If a second recipient's name appears on the NR4 slip, the initial of the second recipient's second given name

</SEC_RCPNT_NM>

<RCPNT_ADDR>

<addr_l1_txt></addr_l1_txt>
Recipient mailing address - line 1
- 30 alphanumeric
- First line of the recipient's address

<addr_l2_txt></addr_l2_txt>
Recipient mailing address - line 2
- 30 alphanumeric
- Second line of the recipient's address

<cty_nm></cty_nm>
Recipient city
- 28 alphanumeric
- Recipient's city

<ste_cd></ste_cd>
Recipient province, territory or state code
- 2 alphanumeric
- Canadian province or territory in which the recipient is located or the state in the USA where the recipient is located
- Use the abbreviations listed in the pdf document entitled “T619 - Electronic media transmittal” under section: Transmitter province or territory code.
- When the recipient's country code is neither CAN nor USA, enter ZZ in this field.

• Armed Forces Codes ? AA-Armed Forces Americas (except Canada)
• AE- Armed Forces Africa
• AE- Armed Forces Canada
• AE- Armed Forces Europe
• AE- Armed Forces Middle East
• AP- Armed Forces Pacific

<cntry_cd></cntry_cd>
Recipient country code
- 3 alpha
- Country in which the recipient is located
- Use the alphabetic country codes outlined in the T4061 Non-resident Withholding Tax Guide."
- Always use CAN for Canada, USA for the United States of America.

<fgn_pstl_cd></fgn_pstl_cd>
Recipient postal code
- 10 alphanumeric
- Recipient's USA zip code or when the recipient's country code is neither CAN nor -
- USA, enter the foreign postal code.

</RCPNT_ADDR>

<tx_cntry_cd></tx_cntry_cd>
Country code for tax purposes
- Required 3 alpha
- NR4 slip, box 12
- Enter the country of residency for tax purposes
- Use the alphabetic country codes as outlined in the International Standard (ISO) 3166
- Codes for the Representation of Names of Countries or use the alphabetic country codes as outlined in the T4061 Non-Resident Withholding Tax Guide.
- Always use CAN for Canada, USA for the United States of America
Note: Only codes outlined in the T4061 guide will be accepted.

<fssn_nbr></fssn_nbr>
Recipient foreign or Canadian tax identification number or social insurance number (SIN)
- Required 20 alphanumeric
- NR4 slip, box 13
- Recipient's FSSN or SIN
- When the recipient has not provided a foreign or Canadian tax identification number (e.g. FSSN) or SIN, enter zeroes in the entire field.

<nr_acct_nbr></nr_acct_nbr>
Non-resident account number
- Required 9 alphanumeric, example: AAA000000
- Your non-resident account number assigned for the filing of your information return with the CRA
- Must correspond to the "Non-resident account number" on the related NR4 Summary record
- If you do not have an account number, call the International Tax Services Office toll free at 1-800-267-3395 or direct at 613-952-2344.

<rcpnt_tcd></rcpnt_tcd>
Recipient type indicator
- Required 1 numeric
- NR4 slip, box 11
- 1 if the recipient is an individual
- 2 if the recipient is a joint account
- 3 if the recipient is a corporation
- 4 if the recipient is an association, a trust (fiduciary-trustee, nominee, or estate), a club, a partnership, or other
- 5 if the recipient is a government, government enterprise, or international organization

<payr_nbr></payr_nbr>
Payer or remitter identification number
- 20 alphanumeric
- Your recipient identification number (i.e., annuitant number, client number) Note: All or a portion of this number should be printed on the information return slip.

<inc_1_tcd></inc_1_tcd>
Income code
- 2 numeric
- NR4 slip, box 14
- See guide T4061, Non-Resident Withholding Tax Guide, for the appropriate numeric income code.

<crcy_1_cd></crcy_1_cd>
Currency code
- 3 alpha
- NR4 slip, box 15
- If financial fields are reported in Canadian dollars (CAD) or in United States dollars (USD), always use the applicable currency code according to International Standard (ISO) 4217 - Codes for the Representation of Currencies and Funds.
- If financial fields are reported in another foreign currency, use the currency codes outlined in the T4061 Non-Resident Withholding Tax Guide.

Note: Only codes outlined in the T4061 guide will be accepted.

<tx_xmpt_1_cd></tx_xmpt_1_cd>
Exemption code
- 1 alpha
- NR4 slip, box 18
- See guide T4061, Non-Resident Withholding Tax Guide, for the appropriate alpha exemption code.

<inc_2_tcd></inc_2_tcd>
Income code
- 2 numeric
- NR4 slip, box 24
- See guide T4061, Non-Resident Withholding Tax Guide, for the appropriate numeric income code. Note: create another slip if more than two income codes.

<crcy_2_cd></crcy_2_cd>
Currency code
- 3 alpha
- NR4 slip, box 25
- If financial fields are reported in Canadian dollars (CAD) or in United States dollars (USD), always use the applicable currency code according to International Standard (ISO) 4217 - Codes for the Representation of Currencies and Funds.
- If financial fields are reported in another foreign currency, use the currency codes outlined in the T4061 Non-Resident Withholding Tax Guide. Note: Only codes outlined in the T4061 guide will be accepted.

<tx_xmpt_2_cd></tx_xmpt_2_cd>
Exemption code
- 1 alpha
- NR4 slip, box 28
- See guide T4061, Non-Resident Withholding Tax Guide, for the appropriate alpha exemption code.

<NR4_AMT>

<gro_1_incamt></gro_1_incamt>
Gross income
- 11 numeric, enter dollars and cents
- NR4 slip, box 16

<nr_tx_1_amt></nr_tx_1_amt>
Non-resident tax withheld
- 11 numeric, enter dollars and cents
- NR4 slip, box 17

<gro_2_incamt></gro_2_incamt>
Gross income
- 11 numeric, enter dollars and cents
- NR4 slip, box 26

<nr_tx_2_amt></nr_tx_2_amt>
Non-resident tax withheld
- 11 numeric, enter dollars and cents
- NR4 slip, box 27

</NR4_AMT>

<rpt_tcd></rpt_tcd>
Report Type Code
- Required 1 alpha
- Originals = O
- Amendments = A
- Cancel = C
Note: An amended return cannot contain an original slip.

</NR4Slip>

<NR4Summary>

<nr_acct_nbr></nr_acct_nbr>
Non-resident account number
- Required 9 alphanumeric, example: AAA000000
- Must correspond to your non-resident account number used on Form NR76, Non-Resident Tax Statement of Account

<PAYR_NM>

<l1_nm></l1_nm>
Payer name - line 1
- Required 30 alphanumeric
- First line of payer's name
- If “&” is used in the name area enter as “&”

<l2_nm></l2_nm>
Payer name - line 2
- 30 alphanumeric
- Second line of payer's name
- If “&” is used in the name area enter as“&”

<l3_nm></l3_nm>
Payer name - line 3
- 30 alphanumeric
- Use for "care of" or "attention"

</PAYR_NM>

<PAYR_ADDR>

<addr_l1_txt></addr_l1_txt>
Payer address - line 1
- 30 alphanumeric
- First line of the payer's address

<addr_l2_txt></addr_l2_txt>
Payer address - line 2
- 30 alphanumeric
- Second line of the payer's address

<cty_nm></cty_nm>
Payer city
- 28 alphanumeric
- City in which the payer is located

<prov_cd></prov_cd>
Payer province or territory code- 2 alpha
- Canadian province or territory in which the payer is located or the state in the USA where the payer is located
- Use the abbreviations listed in the pdf document entitled “T619 - Electronic media transmittal” under section: Transmitter province or territory code.
- When the payer's country code is neither CAN nor USA, enter ZZ in this field.

<cntry_cd></cntry_cd>
Payer country code
- 3 alpha
- Country in which the payer is located
- Use the alphabetic country codes outlined in the International Standard (ISO) 3166 Codes for the Representation of Names of Countries.
- Always use CAN for Canada, and USA for the United States of America.

<pstl_cd></pstl_cd>
Payer postal code
- 10 alphanumeric
- Payer's Canadian postal code, example: A9A9A9, format: alpha, numeric, alpha, numeric, alpha, numeric
- or the payer's USA zip code
- or when the payer's country code is neither CAN nor USA, enter the foreign postal code

</PAYR_ADDR>

<CNTC>

<cntc_nm></cntc_nm>
Contact name
- Required 22 alphanumeric
- Contact's first name followed by surname for this information return
- Omit titles such as Mr., Mrs., etc.

<cntc_area_cd></cntc_area_cd>
Contact area code
- Required 3 numeric
- Area code of telephone number

<cntc_phn_nbr></cntc_phn_nbr>
Contact telephone number
- Required 3 numeric with a (-), followed by 4 numeric.
- Telephone number of contact

<cntc_extn_nbr></cntc_extn_nbr>
Contact extension
- 5 numeric
- Extension number of contact

</CNTC>

<tx_yr></tx_yr>
Taxation year
- Required 4 numeric
- Tax year (e.g., 9999)

<slp_cnt></slp_cnt>
Total number of NR4 slip records
- Required 7 numeric
- Total number of NR4 slip records filed with this NR4 Summary

<rpt_tcd></rpt_tcd>
Report Type Code
- Required 1 alpha
- Originals = O
- Amendments = A
Note: An amended return cannot contain an original slip.

<NR4_TAMT>
Note: The total amount attributed to tot_incamt="0.00" should reflect the combined total of the income fields: tot_gro_1_incamt, tot_gro_2_incamt, and tot_nrpt_incamt. The total amount attributed to tot_tx_wthld="0.00" should reflect the combined total of the tax withheld fields: tot_nr_tx_1_amt, tot_nr_tx_2_amt, and tot_nr_nrpt_tx_amt.

<tot_gro_1_incamt></tot_gro_1_incamt>
Total gross income
- 13 numeric, enter dollars and cents
- Accumulated total of gross income, box 16, as reported on the NR4 slips filed with this NR4 Summary

<tot_nr_tx_1_amt></tot_nr_tx_1_amt>
Total non-resident tax withheld
- 13 numeric, enter dollars and cents
- Accumulated total of non-resident tax withheld, box 17, as reported on the NR4 slips filed with this NR4 Summary

<tot_gro_2_incamt></tot_gro_2_incamt>
Total gross income
- 13 numeric, enter dollars and cents
- Total of gross income, box 26, as reported on the NR4 slips filed with this NR4 Summary

<tot_nr_tx_2_amt></tot_nr_tx_2_amt>
Total non-resident tax withheld
- 13 numeric, enter dollars and cents
- Total of non-resident tax withheld, box 27, as reported on the NR4 slips filed with this NR4 Summary

<tot_nrpt_incamt></tot_nrpt_incamt>
Total gross income REPORTED on NR601 and NR602
- 13 numeric, enter dollars and cents - enter the total in box 26.
- Combined total of gross income already reported on Forms NR601, Non- Resident Ownership Certificate - Withholding Tax, and NR602, Non-Resident Ownership Certificate - No Withholding Tax
Note: See guide T4061, Non-Resident Withholding Tax Guide, for details.

<tot_nr_nrpt_tx_amt></tot_nr_nrpt_tx_amt>
Total non-resident tax withheld REPORTED on NR601
- 13 numeric, enter dollars and cents
- Enter the total in box 28.
- Total of non-resident tax amounts already reported on Forms NR601, Non- Resident Ownership Certificate - Withholding Tax,
Note: See guide T4061, Non-Resident Withholding Tax Guide, for further details

</NR4_TAMT>

</NR4Summary>

</NR4>

</Return>

Date modified:

2016-10-27