Section F – Entitlements to amounts or benefits

Name and address of the entity providing the entitlement or benefit

Enter the name and complete address of each entity providing an entitlement or benefit to a participant for this tax shelter. Follow the instructions for Complete address.

You have to list any of the arrangement entities that will be supplying the investment or insurance contracts to the person acquiring the tax shelter. Include:

• the arrangement entities;
• any related or non-arm's length entity;
• "preferred investment dealers" (those promoted by any of the arrangement entities, or a promoter or any associated entity to provide investments or insurance to participants);
• any series of arrangements flowing through other persons or entities (include a flowchart showing the flow of funds); and
• for tax shelters other than gifting arrangements, if there are investments or insurance contracts, you have to list any of the entities providing an entitlement to an amount or benefit that would have the effect of reducing in whole or in part, the impact of any loss on their investment in the tax shelter to participants. These amounts or benefits include:
  • contingent liabilities;
  • guarantees;
  • securities;
  • indemnification agreements;
  • limited-recourse amounts;
  • government assistance;
  • revenue guarantees; and
  • debt forgiveness.

Arm's length with the principal promoter?

For each entity, tick () the appropriate column.

Additional information required

Attach to the application any draft agreement or similar document that will be offered to the participants. If all agreements are the same, send one blank copy of the agreement. If agreements vary from one participant to another, send one copy of each agreement that is different. Include arrangements between potential participants and third parties (where such arrangements are to be used to promote the sale of the tax shelter, or forms part of the arrangement).

If you need more information about non-arm's length, see the Income tax folio S1-F5-C1, Related Persons and Dealing at Arm’s Length.

If there is not enough space, attach a separate sheet using the same format as on this form.

Forms and publications

• Form T5001, Application for Tax Shelter Identification Number and Undertaking to Keep Books and Records
• Income tax folio S1 F5 C1, Related Persons and Dealing at Arm’s Length

Date modified:

2016-03-04