AXÈ · CPA

General information

Last Name

First Name

Home phone

Province of the residence on December 31, 2022

Birth date

Email

Address

Gender

Have you moved during 2022?

Did you sell your house in 2022?

Was it your main residence?

Please provide us with information regarding buying, selling, selling fees and other upgrades if applicable.

Date the residence was purchased

Amount the residence was sold

Address of residence

My tax return for last year was produced by Axè CPA

Are you a Canadian citizen?

Indicate your citizenship

Marital Status on December 31, 2022:

Has there been a change in your marital status during the year 2021:

Indicate the date

Are we doing your spouse’s income tax

Spouse's last name

Spouse's SIN

Spouse's first name

Please provide income for the year

Line 236 federal

Line 275 Quebec

Last Name

Birth Date

Home Phone

Province of the residence on December 31, 2022

First Name

Address

Email

Has the spouse moved during the year 2022?

Did the spouse sell a residence in 2022?

Has the information already been written on the previous page?

Was this your main residence?

Please provide us with information regarding buying, selling, selling fees and other upgrades if applicable.

Date of purchase of the residence sold

Amount of the sale of the residence sold

Address of residence sold

Have you lived alone for the WHOLE year? (or only with minors or adults who are pursuing post-secondary studies)

Habitation, on December 31, 2022

Owner

Tenant (Provide statement 31)

Other

If other, please add details.

Is it the same answer for your spouse?

No

Yes

Habitation, on December 31, 2022, your spouse was

Owner

Tenant (Provide statement 31)

Other

If other, please add details.

Have you purchased your first residence this year?

Date purchased

Co-owner

Complete address

Medical Insurance

Indicate EVERY month of the year :

RAMQ (from)

My group insurance plan (from)

Group insurance plan (spouse/parent) (from)

RAMQ (to)

My group insurance plan (to)

Group insurance plan (spouse/parent) (to)

Is it the same answer for your spouse?

No

Yes

RAMQ (from)

My group insurance plan (from)

Group insurance plan (spouse/parent) (from)

RAMQ (to)

My group insurance plan (to)

Group insurance plan (spouse/parent) (to)

Do you have declared drug costs not reimbursed by your insurance?

Have you made an RRSP contribution for 2022?

Please send us your receipts with your documents

Has the spouse made an RRSP contribution for the year 2022?

Please send us your receipts with your documents

Have you made a RAP contribution during the year 2022?

Please enter the date of withdrawal

Please enter the withdrawal amount

Did the spouse make a RAP during the year 2022?

Please enter the date of withdrawal (spouse)

Please enter the withdrawal amount (spouse)

Did you own or hold specified foreign property where the total cost amount of all such property in any time in 2021, was more than CASN$100,000?

Complete the T1135 form and send it to us with your documents

Does the spouse own more than $100,000 in foreign assets?

Complete the T1135 form and send it to us with your documents

Are you registered for direct deposit? (Send us a specimen check with your documents if you wish)

Is the spouse registered for direct deposit?

Are you eligible for Disability tax credit (DTC)?

Is the spouse eligible for Disability tax credit (DTC)?

Dependant child, parent or grand-parent

Information on dependent children, parent or grand-parent

Last Name	First Name	Birth Date	SIN	Post-secondary and professional student	Did he earn any income during the year

Have you been a single parent during any time in 2022?

Has your spouse been a single parent at any time during the year?

Name of the dependent child for the federal credit application (Please note, you must be the only person declaring this dependent child otherwise the application is automatically refused by the CRA)

Please indicate if you have shared custody of dependent children with a former spouse, if your child is disabled, other information.

Have you worked from home due to COVID- 19 for at least 4 consecutive weeks (more than 50% of the time) in 2022?

Yes

No

Do you want to opt for the simplified deduction (2$ per day, up to 500$)?

Yes

No

Please bring the T2200 form signed from your employer as well as the supporting documents for your expenses.

18. OTHER INFORMATION / CREDITS / CHANGES TO INFORM US

Desired delivery method:

Electronic signatures and digital documents via the portal (preferred method)

In person (paper) (extra $ 7.50)

Client meeting

Without appointment

Appointment with an accountant (minimum $ 50)

I consent that my documents could leave the Axè CPA offices for teleworking; If not, I refuse that my physical documents leave the offices and I understand that the processing time of my file could be longer, which could compromise the transmission before the deadline to government authorities.

Yes

No

I consent that my documents could leave the Axè CPA offices for teleworking, in order to follow government directives regarding COVID-19. If not, I refuse that my physical documents leave the offices and I understand that the processing time of my file will be longer, which could compromise the transmission before the deadline to government authorities.

Yes

I confirm that I am aware that I must sign the authorizations to send my tax returns once they have been produced by Axè CPA before the filing deadline. Failing to sign them, Axè CPA will not be authorized to transmit my declarations and therefore cannot be held responsible for any penalties and interest that this delay may cause.

Yes

Yes, I have read and accept the billing rate grid. ATTENTION: READ THE RATE CAREFULLY, AS INCREASES HAVE BEEN MADE, PLEASE MAKE SURE YOU AGREE TO THE NEW RATES.

Yes

See the fee schedule

I am responsible and accurate for the information and completeness of the statements contained in my income tax returns under the Income Tax Act of Canada and the Quebec Taxation Act.

I (we) declare (us) that the information contained in this questionnaire is true. I (we) confirm (us) that all sources of income have been disclosed (Canadian and foreign), that all deducted expenses have been incurred to earn income and that all requested credits are supported by receipts when required.

Taxpayer signature

Spouse signature (if needed)