T5 Statement of Investment Income

2017V1 - updated 2016-10-27

<Return>

<T5>

<T5Slip>
Note: When completing the T5 return, include either the Corporation Information or the Recipient Information, NOT both.

<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>

<sec_snm></sec_snm>
Second individual recipient surname
- Required 20 alphanumeric
- If a second recipient's name appears on the T5 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 T5 slip, the first 12 letters of the second recipient's first given name
Note: If only initials are available, provide the second recipient's first initial.

<sec_init></sec_init>
Second individual recipient initial
- 1 alphanumeric
- If a second recipient's name appears on the T5 slip, the initial of the second recipient's second given name

</SEC_RCPNT_NM>

<sin></sin>
Individual recipient social insurance number (SIN)
- Required 9 numeric
- T5 slip, box 22
- Recipient's SIN
- When the recipient has failed to provide a SIN, enter zeroes in the entire field.

<sbrn_root></sbrn_root>
Recipient Business Number (BN)
- required 9 numeric
- T5 slip, box 22
- The first 9 digits of the recipient's BN assigned by the CRA
- when the recipient has failed to provide a BN, enter zeroes in the field.

<rcpnt_tr_acct_nbr></rcpnt_tr_acct_nbr>
Recipient Trust Account Number
- 1 alpha, 8 numeric
- Must correspond to the "Trust account number" assigned by the CRA
- When the recipient has failed to provide a "Trust account number", enter T00000000 in the field.

<BUS_NM>

<l1_nm></l1_nm>
Corporation, organization, association, or institution recipient name - line 1
- Required 30 alphanumeric
- First line of the recipient corporation, organization, association, or institution's name
- If "&" is used in the name area enter as "&amp;"

<l2_nm></l2_nm>
Corporation, organization, association, or institution recipient name - line 2
- 30 alphanumeric
- Second line of the recipient corporation, organization, association, or institution's name

</BUS_NM>

<RCPNT_ADDR>

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

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

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

<prov_cd></prov_cd>
Recipient province or territory code
- 2 alpha
- 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
- 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 CAN for Canada, and USA for the United States of America

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

</RCPNT_ADDR>

<bn></bn>
Account Number
For Original returns:
- Required, 15 alphanumeric, 9 digits RZ 4 digits, example 000000000RZ0000
- Must correspond to the Account number on the related T5 Summary record.
- If you have not been notified of your number, or you are unsure of your number, contact our Business Enquiries line at 1-800-959-5525.

For Amended returns:
- Required, enter the same Account number used in the original filed return.
- For 2008 and prior tax year amendments, enter the filer identification number, example HA0000000.
- For 2009 and subsequent tax year amendments, enter the BN RZ, example 000000000RZ0000.
Note: In order to process a return, the complete Account number is required.

<rcpnt_fi_br_nbr></rcpnt_fi_br_nbr>
Recipient bank transit number
- Required 8 alphanumeric
- T5 slip, box 28
- The transit number assigned to the recipient's bank branch
- when an institution does not have a bank transit number, enter zeroes in the field.

<rcpnt_fi_acct_nbr></rcpnt_fi_acct_nbr>
Recipient account number
- Required 12 alphanumeric
- T5 slip, box 29
- The account number to which the interest income applies
- When an institution does not issue recipient account numbers, enter zeroes in the field.

<rpt_tcd></rpt_tcd>
Report code
- Required 1 alpha
- T5 slip, box 21
- Originals = O
- Amendments = A
- Cancel = C
Note: An amended return cannot contain an original slip.

<rcpnt_tcd></rcpnt_tcd>
Recipient type indicator
- Required 1 numeric
- T5 slip, box 23
- 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 institution

<fgn_crcy_ind></fgn_crcy_ind>
Foreign currency indicator
- 3 alpha
- T5 slip, box 27
- If financial fields are reported in a foreign currency, identify by using the applicable currency code according to International Standard (ISO) 4217 – Codes for the Representation of Currencies and Funds.
- Always CAD if financial fields are reported in Canadian dollars

<T5_AMT>
For all of the T5 amounts enter dollars and cents.

<actl_dvnd_amt></actl_dvnd_amt>
Actual amount of dividends other than eligible dividends
- 11 numeric
- T5 slip, box 10

<tx_dvnd_amt></tx_dvnd_amt>
Taxable amount of dividends other than eligible dividends
- 11 numeric
- T5 slip, box 11

<dvnd_tx_cr_amt></dvnd_tx_cr_amt>
Dividend tax credit for dividends other than eligible dividends
- 11 numeric
- T5 slip, box 12

<cdn_int_amt></cdn_int_amt>
Interest from Canadian sources
- 13 numeric
- T5 slip, box 13

<oth_cdn_incamt></oth_cdn_incamt>
Other income from Canadian sources
- 11 numeric
- T5 slip, box 14

<fgn_incamt></fgn_incamt>
Foreign income
- 11 numeric
- T5 slip, box 15
<fgn_tx_pay_amt></fgn_tx_pay_amt>
Foreign tax paid
- 11 numeric
- T5 slip, box 16

<cdn_royl_amt></cdn_royl_amt>
Royalties from Canadian sources
- 11 numeric
- T5 slip, box 17

<cgain_dvnd_amt></cgain_dvnd_amt>
Capital gains dividends
- 11 numeric
- T5 slip, box 18
- For tax years after 2000, report the full amount from January 1, to December 31.
- For the tax year 2000, report the amount from October 18, 2000 to December 31, 2000.
- 50% rate.

<acr_annty_amt></acr_annty_amt>
Accrued income - annuities
- 11 numeric
- T5 slip, box 19

<rsrc_alwnc_amt></rsrc_alwnc_amt>
Amount eligible for resource allowance deduction
- 11 numeric
- T5 slip, box 20

<actl_elg_dvamt></actl_elg_dvamt>
Actual amount of eligible dividends
- 11 numeric
- T5 slip, box 24

<tx_elg_dvnd_pamt></tx_elg_dvnd_pamt>
Taxable amount of eligible dividends
- 11 numeric
- T5 slip, box 25

<enhn_dvtc_amt></enhn_dvtc_amt>
Dividend tax credit for eligible dividends
- 11 numeric
- T5 slip, box 26

<cgain_dvnd_1_amt></cgain_dvnd_1_amt>
Capital gains dividends Period 1
- 11 numeric
- T5 slip box 40
- For the tax year 2000, report the amount from January 1, 2000 to February 27, 2000.
- 75% rate

<cgain_dvnd_2_amt></cgain_dvnd_2_amt>
Capital gains dividends Period 2
- 11 numeric
- T5 slip box 41
- For the tax year 2000, report the amount from February 28, 2000 to October 17, 2000.
- 66.6% rate

</T5_AMT>

</T5Slip>

<T5Summary>

<bn></bn>
Account Number
For Original returns:
- Required, 15 alphanumeric, 9 digits RZ 4 digits, example 000000000RZ0000
- The Account number assigned to file the T5 information return with CRA.
- If you have not been notified of your number, or you are unsure of your number, contact our Business Enquiries line at 1-800-959-5525.

For Amended returns:
- Required, enter the same Account number used in the original filed return.
- For 2008 and prior tax year amendments, enter the filer identification number, example HA0000000.
- For 2009 and subsequent tax year amendments, enter the BN RZ, example 000000000RZ0000.
Note: In order to process a return, the complete Account number is required.

<FILR_NM>

<l1_nm></l1_nm>
Filer name - line 1
- Required 30 alphanumeric
- First line of filer's name
- If "&" is used in the name area enter as "&amp;"

<l2_nm></l2_nm>
Filer name - line 2
- 30 alphanumeric
- Second line of filer's name
<l3_nm></l3_nm>
Filer name - line 3
- 30 alphanumeric
- Use for "care of" or "attention"

</FILR_NM>

<FILR_ADDR>

<addr_l1_txt></addr_l1_txt>
Filer address - line 1
- Required 30 alphanumeric
- First line of the filer's address

<addr_l2_txt></addr_l2_txt>
Filer address - line 2
- 30 alphanumeric
- Second line of the filer's address

<cty_nm></cty_nm>
Filer city
- 28 alphanumeric
- City in which the filer is located

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

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

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

</FILR_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 contact

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

</CNTC>

<filr_fi_br_nbr></filr_fi_br_nbr>
Filer bank transit number
- Required 8 alphanumeric
- Use only when you are reporting interest income
- The transit number assigned to the bank
- When an institution does not have a bank transit number, enter zeroes in the field.

<tx_yr></tx_yr>
Taxation year
- Required 4 numeric
- The tax year (e.g., 2001)

<slp_cnt></slp_cnt>
Number of T5 slip records
- required 7 numeric
- Total number of T5 slip records for this T5 Summary record

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

<T5_TAMT>

<tot_cdn_int_amt></tot_cdn_int_amt>
Total interest from Canadian sources
- 15 numeric
- Accumulated total of recipients' interest from Canadian sources, as reported on the T5 slip records filed with this T5 Summary

Note: For the following amounts, field limits are set to13 numeric. Enter dollars and cents.

<tot_actl_dvnd_amt></tot_actl_dvnd_amt>
Total actual amount of dividends other than eligible dividends
- Accumulated total of recipients' actual amount of dividends other than eligible dividends, as reported on the T5 slip records filed with this T5 Summary

<tot_actl_elg_dvamt></tot_actl_elg_dvamt>
Total actual amount of eligible dividends
- Accumulated total of recipients' actual amount of eligible dividends, as reported on the T5 slip records filed with this T5 Summary

<tot_tx_elg_dvamt></tot_tx_elg_dvamt>
Total taxable amount of eligible dividends
- Accumulated total of recipients' taxable amount of eligible dividends, as reported on the T5 slip records filed with this T5 Summary

<tot_enhn_dvtc_amt></tot_enhn_dvtc_amt>
Total dividend tax credit for eligible dividends
- Accumulated total of recipients' dividend tax credit for eligible dividends, as reported on the T5 slip records filed with this T5 Summary

<tot_tx_dvnd_amt></tot_tx_dvnd_amt>
Total taxable amount of dividends other than eligible dividends
- Accumulated total of recipients' taxable amount of dividends, as reported on the T5 slip records filed with this T5 Summary
- Total taxable amount of dividends other than eligible dividends

<tot_dvnd_tx_cr_amt></tot_dvnd_tx_cr_amt>
Total dividend tax credit for dividends other than eligible dividends
- Accumulated total of recipients' total dividend tax credit for dividends other than eligible dividends, as reported on the T5 slip records filed with this T5 Summary
<totr_cdn_incamt></totr_cdn_incamt>
Total other income from Canadian sources
- Accumulated total of recipients' other income from Canadian sources, as reported on the T5 slip records filed with this T5 Summary

<tot_fgn_incamt></tot_fgn_incamt>
Total foreign income
- Accumulated total of recipients' foreign income, as reported on the T5 slip records filed with this T5 Summary

<tot_fgn_tx_pay_amt></tot_fgn_tx_pay_amt>
Total foreign tax paid
- Accumulated total of recipients' foreign tax paid, as reported on the T5 slip records filed with this T5 Summary

<tot_cdn_royl_amt></tot_cdn_royl_amt>
Total royalties from Canadian sources
- Accumulated total of recipients' royalties from Canadian sources, as reported on the T5 slip records filed with this T5 Summary

<tot_cgain_dvnd_amt></tot_cgain_dvnd_amt>
Total capital gains dividends
- Accumulated total of recipients' capital gains dividends, as reported in boxes 18, 40 and 41 on the T5 slip records filed with this T5 Summary

<tot_acr_annty_amt></tot_acr_annty_amt>
Total accrued income - annuities
- Accumulated total of recipients' accrued income annuities, as reported on the T5 slip records filed with this T5 Summary

<tot_rsrc_alwnc_amt></tot_rsrc_alwnc_amt>
Total amount eligible for resource allowance deduction
- Accumulated total of recipients' amount eligible for resource allowance deduction, as reported on the T5 slip records filed with this T5 Summary

</T5_TAMT>

</T5Summary>

</T5>

</Return>

Date modified:

2016-10-27