T4A Statement of Pension, Retirement, Annuity, and Other Income

2017V1 - updated 2016-10-27

<Return>

<T4A>

<T4ASlip>
Note: When completing the T4A return, include either the Corporation Information or
the Recipient Information, NOT both.

<RCPNT_NM>
Note: leave blank if a corporation

<snm></snm>
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>
Recipient first name
- 12 alphanumeric
- first 12 letters of the recipient’s first given name
- if only initials are available, provide the recipient’s first initial.

<init></init>
Recipient initial
- 1 alpha
- initial of the recipient’s second given name
</RCPNT_NM>

<sin></sin>
Recipient social insurance number (SIN)
- required, 9 numeric
- T4A slip, box 012
- where the recipient has failed to provide a SIN, or is filing for a corporation enter
zeroes in the field.
- omission of a valid SIN results in non-registration of contributions to the Canada
Pension Plan.

<rcpnt_bn></rcpnt_bn>
Recipient Business Number (BN)
- required, 15 alphanumeric (9 digits RP 4 digits)
- T4A slip, box 013
- where the recipient has failed to provide a BN or is filing for an individual enter the
example: 000000000RP0000 in the field.
- to process a return, the complete BN is required.
<RCPNT_CORP_NM>
Note: Leave blank if an individual.

<l1_nm></l1_nm>
Recipient corporation or partnership name - line 1
- required 30 alphanumeric
- the first line of the recipient's name
- if "&" is used in the name area enter as "&amp;"

<l2_nm></l2_nm>
Recipient corporation or partnership name - line 2
- 30 alphanumeric
- the second line of the recipient's name

</RCPNT_CORP_NM>

<RCPNT_ADDR>

<addr_l1_txt></addr_l1_txt>
Recipient address - line 1
- 30 alphanumeric
- the first line of the recipient’s address

<addr_l2_txt></addr_l2_txt>
Recipient address - line 2
- 30 alphanumeric
- the second line of the recipient’s address

<cty_nm></cty_nm>
Recipient city
- 28 alphanumeric
- the city in which the recipient is located.

<prov_cd></prov_cd>
Recipient province or territory code
- 2 alpha
- the 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.

<cntry_cd></cntry_cd>
Recipient country code
- 3 alpha
- the country in which the recipient is located
- use the alphabetic country codes as 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>
Recipient postal code
- 10 alphanumeric
- the recipient’s Canadian postal code, format: alpha, numeric, alpha, numeric,
alpha, numeric, example: A9A9A9
- or the recipient’s USA zip code
- or where the recipient’s country code is neither CAN nor USA, enter the foreign
postal code

</RCPNT_ADDR>

<rcpnt_nbr></rcpnt_nbr>
Recipient number
- T4A slip, code 014
- 20 alphanumeric
- for example: region and/or branch payroll and/or department and/or recipient
number

<bn></bn>
Payer's Account Number (BN)
- required 15 alphanumeric, 9 digits RP 4 digits, example:000000000RP0000
- T4A slip, box 061
- must correspond to the "Account Number (BN)" on the related T4A Summary
record
- enter the Account Number as used on Form PD7A, Statement of Account for
Current Source Deductions.
Note: In order to process a return, the complete BN is required.

<ppln_dpsp_rgst_nbr></ppln_dpsp_rgst_nbr>
Plan or DPSP registration number
- 7 numeric
- T4A slip, code 036
- enter the registration number issued by the CRA for the plan where the most
amount of pension adjustment was reported.

<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.

<T4A_AMT>
The field limits for all of the following are set at 11 numeric characters. Enter dollars
& cents.
<pens_spran_amt></pens_spran_amt>
Pension or superannuation
- T4A slip, box 016

<lsp_amt></lsp_amt>
Lump-sum payments
- T4A slip, box 018

<self_empl_cmsn_amt></self_empl_cmsn_amt>
Self-employed commissions
- T4A slip, box 020

<itx_ddct_amt></itx_ddct_amt>
Income tax deducted
- T4A slip, box 022

<annty_amt></annty_amt>
Annuities
- T4A slip, box 024

<fee_or_oth_srvc_amt></fee_or_oth_srvc_amt>
Fees for services
-T4A slip, box 048

</T4A_AMT>

<OTH_INFO>
Note: All of the other information amounts are from the Other Information fields at
the bottom of the T4A slip.
- if more than twelve (12) Other Information Fields are used, create an additional
T4A slip to report the additional amounts.
- 11 numeric
- enter dollars & cents

<elg_rtir_amt></elg_rtir_amt>
Eligible retiring allowances
- T4A slip, code 026
- valid for 2009 and prior taxation years only

<nelg_rtir_amt></nelg_rtir_amt>
Non-eligible retiring allowances
- T4A slip, code 027
- valid for 2009 and prior taxation years only

<oth_incamt></oth_incamt>
Other income
- T4A slip, code 028

<ptrng_aloc_amt></ptrng_aloc_amt>
Patronage allocations
- T4A slip, code 030

<rpp_past_srvc_amt></rpp_past_srvc_amt>
Registered pension plan contributions (past service)
- T4A slip, code 032

<padj_amt></padj_amt>
Pension adjustment
- T4A slip, code 034

<resp_aip_amt></resp_aip_amt>
RESP accumulated income payments
- T4A slip, code 040

<resp_educt_ast_amt></resp_educt_ast_amt>
RESP educational assistance payments
- T4A slip, code 042

<chrty_dons_amt></chrty_dons_amt>
Charitable donations
-T4A slip, code 046

<nr_lsp_trnsf_amt></nr_lsp_trnsf_amt>
Lump-sum payments - non-resident services transferred under
paragraph 60(j)
- T4A slip, code 102
- indicate the lump-sum, if any, included in "Lump-sum payments" that represents an
amount paid for benefits for non-resident services transferred under paragraph 60(j).

<rsch_grnt_amt></rsch_grnt_amt>
Research grants
- T4A slip, code 104
- indicate the amount, if any that represents a research grant

<brsy_amt></brsy_amt>
Scholarships, fellowships, or bursaries
- T4A slip, code 105
- indicate the amount, if any that represents scholarships, fellowships, or bursaries.

<dth_ben_amt></dth_ben_amt>
Death benefits
- T4A slip, code 106
- indicate the amount, if any that represents death benefits.

<wag_ls_incamt></wag_ls_incamt>
Income from wage loss replacement plans, not fully funded by employee
premiums
- T4A slip, code 107
- indicate the amount, if any that represents income from a wage loss replacement plan that is not fully funded by employee premiums.

<lsp_rpp_nelg_amt></lsp_rpp_nelg_amt>
Lump-sum payments out of an RPP - not eligible for transfer
- T4A slip, code 108
- indicate the lump-sum that we consider as income, if any, included in "Lump-sum
payments" that represents an amount paid out of an RPP to an individual .

<nrgst_ppln_amt></nrgst_ppln_amt>
Unregistered pension plan
- T4A slip, code 109
- indicate the amount, if any, that represents amounts paid from a pension fund, or
plan that is not registered.

<pr_71_acr_lsp_amt></pr_71_acr_lsp_amt>
Lump-sum payments accrued to December 31, 1971
- T4A slip, code 110
- indicate the amount, if any, included in the "Lump-sum payments" that accrued to
December 31, 1971.

<inc_avg_annty_amt></inc_avg_annty_amt>
IAAC annuities
- T4A slip, code 111
- indicate the amount, if any, included in "Annuities" that represents income averaging annuity contract (IAAC) payments.

<dpsp_ins_pay_amt></dpsp_ins_pay_amt>
Installment or annuity payments under a DPSP
- T4A slip, code 115
- indicate the amount, if any, included in "Annuities" that represents an installment or
annuity payment under a deferred profit-sharing plan (DPSP).

<med_trvl_amt></med_trvl_amt>
Medical travel
- T4A slip, code 116
- indicate the amount, if any that represents medical travel assistance for an employee who normally lives in a prescribed zone and works at a special work site in a prescribed zone.

<loan_ben_amt></loan_ben_amt>
Loan benefit under subsection 80.4(2)
- T4A slip, code 117
- indicate the amount, if any that represents loans received because of shareholding.

<med_prem_ben_amt></med_prem_ben_amt>
Medical premium benefit
- T4A slip, code 118
- indicate the amount, if any that represents a premium or contribution made on behalf of an employee, or a retired person to a provincial health services insurance plan.

<grp_trm_life_amt></grp_trm_life_amt>
Group term life insurance benefit
- T4A slip, code 119
- indicate the amount, if any that represents a group term life insurance benefit.

<resp_aip_oth_amt></resp_aip_oth_amt>
RESP accumulated income payments to other
-T4A slip, code 122
- indicate the amount, if any, included in RESP accumulated income that represents
payments paid to someone other than the subscriber or subscriber's spouse or
common-law partner

<ins_rvk_dpsp_amt></ins_rvk_dpsp_amt>
Instalment or annuity payments under a revoked DPSP
- T4A slip, code 123
- indicate the amount, if any that represents an installment or annuity payment under a revoked deferred profit-sharing plan (DPSP).

<brd_wrk_site_amt></brd_wrk_site_amt>
Board and lodging at special work sites
- T4A slip, code 124
- enter only the exempted portion of the board and lodging benefits for an employee
who does not normally live in a prescribed zone but works at a work site in a
prescribed zone, and meets the residency requirements for the northern residents
deductions.

<dsblt_ben_amt></dsblt_ben_amt>
Disability benefits
- T4A slip, code 125
- indicate the amount, if any that represents disability benefits paid out of a superannuation or pension plan.

<cntrbr_prr_pspp_cnamt></cntrbr_prr_pspp_cnamt>
- Contributor RPP Past Service pre-1990 contributions
T4A slip, code 126
- indicate the amount, if any included in Registered pension plan contributions (pre-1990 past service) while a contributor

<vtrn_ben_amt></vtrn_ben_amt>
Veteran’s benefit
- T4A slip, code 127
- indicate the amount, if any that represents a veteran’s benefit.

<tx_dfr_ptrng_dvamt></tx_dfr_ptrng_dvamt>
Tax deferred patronage dividends
- T4A slip, code 129
- indicate the amount that represents tax deferred patronage dividends.

<atp_inctv_grnt_amt></atp_inctv_grnt_amt>
Apprenticeship Incentive Grant/Apprenticeship Completion Grant
- T4A slip, code 130
- indicate the amount, if any that represents an apprenticeship incentive grant and apprenticeship completion grant.

<rdsp_amt></rdsp_amt>
Registered Disability Savings Plan
- T4A slip, code 131
- indicate the amount, if any that represents a registered disability savings plan amount.

<wag_ptct_pgm_amt></wag_ptct_pgm_amt>
Wage Earner Protection Program
- T4A slip, code 132
- indicate the amount, if any, included in "Other income" that represents a wage
earner protection program amount.

<var_pens_ben_amt></var_pens_ben_amt>
Variable Pension Benefits
- T4A slip, code 133
- indicate the amount, if any that represents a variable pension benefits amount.

<tfsa_tax_amt></tfsa_tax_amt>
TFSA taxable amount
- T4A slip, code 134

<rcpnt_pay_prem_phsp_amt></rcpnt_pay_prem_phsp_amt>
Recipient-paid premiums for private health services plans
-T4A slip, code 135

<pmmc_isg_amt></pmmc_isg_amt>
Federal Income Support for Parents of Murdered or Missing Children grant (PMMC)
T4A slip, code 136

<indn_elg_rtir_amt></indn_elg_rtir_amt>
Status Indian (exempt income) - eligible retiring allowances
- T4A slip, code 142
- indicate the exempt amount, if any, included in "Eligible retiring allowances".
- valid for 2009 and prior taxation years only

<indn_nelg_rtir_amt></indn_nelg_rtir_amt>
Status Indian (exempt income) - non-eligible retiring allowances
- T4A slip, code 143
- indicate the exempt amount, if any, included in "non-eligible retiring allowances".
- valid for 2009 and prior taxation years only

<indn_oth_incamt></indn_oth_incamt>
Status Indian (exempt income) - other income
- T4A slip, code 144
- indicate the exempt amount, if any.

<indn_xmpt_pens_amt></indn_xmpt_pens_amt>
Status Indian (exempt income) - pension or superannuation
- T4A slip, code 146
- indicate the exempt amount, if any, included in "Pension or superannuation"

<indn_xmpt_lsp_amt></indn_xmpt_lsp_amt>
Status Indian (exempt income) - lump-sum payments
- T4A slip, code 148
- indicate the exempt amount, if any, included in "Lump-sum payments".

<lbr_adj_ben_aprpt_act_amt></lbr_adj_ben_aprpt_act_amt>
Labour Adjustment Benefits Act and Appropriation Act
-T4A slip, code 150

<subp_qlf_amt></subp_qlf_amt>
SUBP qualified under the Income Tax Act
-T4A slip, code 152

<csh_awrd_pze_payr_amt></csh_awrd_pze_payr_amt>
Cash award or prize from payer
-T4A slip, code 154

<bkcy_sttl_amt></bkcy_sttl_amt>
Bankruptcy settlement
-T4A slip, code 156

<lsp_nelg_trnsf_amt></lsp_nelg_trnsf_amt>
Lump-sum payments - not eligible for transfer
- T4A slip, code 158
- indicate the lump-sum that we consider as income, if any, included in "Lump-sum
payments" that represents an amount that was not eligible for transfer.

<ncntrbr_prr_pspp_cnamt></ncntrbr_prr_pspp_cnamt >
Non Contributor RPP Past Service pre-1990 contributions
- T4A slip, code 162
- indicate the amount, if any, included in Registered pension plan contributions (pre-1990 past service) while not a contributor.

<lsp_dpsp_nelg_amt></lsp_dpsp_nelg_amt>
Lump-sum payments out of a DPSP - not eligible for transfer
- T4A slip, code 180
- indicate the lump-sum, if any, included in "Lump-sum payments" that represents an
amount paid out of a DPSP that is not eligible for transfer.

<lsp_nrgst_pens_amt></lsp_nrgst_pens_amt>
Lump-sum payments - unregistered pension benefits
- T4A slip, code 190
- indicate the lump-sum, if any, included in "Lump-sum payments" that represents an
amount paid from an unregistered pension benefits fund or plan.

<prpp_tx_inc_pamt>></prpp_tx_inc_pamt>
PRPP payments from taxable income
T4A slip, code 194

<prpp_txmpt_inc_pamt></ prpp_txmpt_inc_pamt>
PRPP payments from exempt income
T4A slip, code 195

<abe_tuit_ast_amt></ abe_tuit_ast_amt>
Adult basic education tuition assistance
T4A slip, code196

</OTH_INFO>

New <ADD_INFO>

Note: For Saskatchewan Government use only

<spp_sps_cntrb_ind></spp_sps_cntrb_ind>
Saskatchewan Pension Plan spousal contributor indicator

<spp_sps_cntrbr_sin></spp_sps_cntrbr_sin>
Saskatchewan Pension Plan spousal contributor social insurance number

</ADD_INFO>

</T4ASlip>

<T4ASummary>

<bn></bn>
Business Number (BN)
- required 15 alphanumeric, 9 digits RP 4 digits, example: 000000000RP0000
Note: In order to process a return, the complete BN is required.

<PAYR_NM>

<l1_nm></l1_nm>
Payer name - line 1
- required 30 alphanumeric
- the first line of payer's name
- if "&" is used in the name area enter as "&amp;"

<l2_nm></l2_nm>
Payer name - line 2
- 30 alphanumeric
- the second line of payer's name

<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
- the first line of the payer's address

<addr_l2_txt></addr_l2_txt>
Payer address - line 2
- 30 alphanumeric
- the second line of the payer's address
<cty_nm></cty_nm>
Payer city
- 28 alphanumeric
- the city in which the payer is located

<prov_cd></prov_cd>
Payer province or territory code
- 2 alpha
- the 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
- the country in which the payer is located
- use the alphabetic country codes as 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
- the payer's Canadian postal code, format: alpha, numeric, alpha, numeric, alpha,
numeric, example: A9A9A9
- 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 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 the contact

<cntc_extn_nbr></cntc_extn_nbr>
Contact extension
- 5 numeric
- extension of the contact

</CNTC>

<tx_yr></tx_yr>
Taxation year
- required 4 numeric
- the taxation year (e.g., 2001)

<slp_cnt></slp_cnt>
Total number of T4A slip records
- required 7 numeric
- total number of T4A slip records filed with this T4A Summary

<RPP_NBR>
Registered pension plan registration number
- 21 numeric = 7 for each plan number.

<rpp_rgst_1_nbr></rpp_rgst_1_nbr>
- enter the number for the pension plan issued by the CRA.

<rpp_rgst_2_nbr></rpp_rgst_2_nbr>
- enter the second registration number

<rpp_rgst_3_nbr></rpp_rgst_3_nbr>
- enter the third registration number

</RPP_NBR>

<PPRTR_SIN>

<pprtr_1_sin></pprtr_1_sin>
Proprietor #1 social insurance number (SIN)
- 9 numeric
- if the employer is a Canadian-controlled private corporation or unincorporated,
enter the SIN of the proprietor #1 or principal owner.

<pprtr_2_sin></pprtr_2_sin>
Proprietor #2 social insurance number (SIN)
- 9 numeric
- if the employer is a Canadian-controlled private corporation or unincorporated,
enter the SIN of the proprietor #2 or second principal owner.

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

<T4A_TAMT>
- the total amounts are those reported from the T4A slips filed with this T4A
Summary. The field length is set for each amount and has been increased to 15 numeric characters except Total income tax deducted which remains at 13 numeric
characters.
- enter dollars & cents.

<tot_pens_spran_amt></tot_pens_spran_amt>
Total pension or superannuation
- accumulated total of recipients' pension or superannuation

<tot_lsp_amt></tot_lsp_amt>
Total lump-sum payments
- accumulated total of recipients' lump-sum payments
Note: Do not include these amounts in line 101

<tot_self_cmsn_amt></tot_self_cmsn_amt>
Total self-employed commissions
- accumulated total of recipients' self-employed commissions

<tot_ptrng_aloc_amt></tot_ptrng_aloc_amt>
Total patronage allocations
- accumulated total of recipients' patronage allocations

<tot_past_srvc_amt></tot_past_srvc_amt>
Total pension plan contributions (past service)
- accumulated total of recipients' pension plan contributions

<tot_annty_incamt></tot_annty_incamt>
Total annuities
- accumulated total of recipients' annuities

<totr_incamt></totr_incamt>
Total other income
- accumulated total of recipients' other income

<tot_itx_dedn_amt></tot_itx_dedn_amt>
Total income tax deducted
- accumulated total of recipients' income tax deductions
- maximum 13 numeric characters, dollars and cents

<tot_padj_amt></tot_padj_amt>
Total pension adjustment
- accumulated total of recipients' pension adjustment

<tot_resp_aip_amt></tot_resp_aip_amt>
Total RESP accumulated income payments
- accumulated total of recipients' RESP accumulated income payments

<tot_resp_amt></tot_resp_amt>
Total RESP educational assistance payments
- accumulated total of recipients' RESP educational assistance payments

<rpt_tot_fee_srvc_amt></rpt_tot_fee_srvc_amt>
Total fees for services
- accumulated total fees for services

<rpt_tot_oth_info_amt></rpt_tot_oth_info_amt>
Total other information amounts
- accumulated total of all other amounts
- total does not include boxes 016, 018, 020, 022, 024, 028, 030, 032, 034, 040, 042,
048, or non-financial boxes 014 and 036.

</T4A_TAMT>

</T4ASummary>

</T4A>

</Return>

Date modified:

2016-10-27