5002-D (Front) 
 
2011 T1 General 
 
Prince Edward Island 
 
Provincial Worksheet 
 
Use these charts to do the calculations you may need to complete Form PE428, 
Prince Edward Island Tax and Credits. 
 
You can find more information about completing these charts in the forms 
book. 
 
Keep this worksheet for your records. Do not attach it to the return you send 
us. 
 
Line 5808 - Age amount 
 
Line 1: Maximum amount 3,764.00 
Line 2: Your net income from line 236 of your return ^
Line 3: Base amount 28,019.00 
Line 4: Line 2 minus line 3 (if negative, enter "0") = ^
Line 5: Applicable rate 15% 
Line 6: Multiply line 4 by line 5. = ^
Line 7: Line 1 minus line 6 (if negative, enter "0") = ^
Enter this amount on line 5808 of Form PE428. 
 
Line 5820 - Amount for infirm dependants age 18 or older 
 
Complete this calculation for each dependant. 
 
Line 1: Base amount 7,412.00 
Line 2: Dependant's net income (line 236 of his or her return) ^
Line 3: Line 1 minus line 2 (if negative, enter "0") (maximum $2,446) = ^
Line 4: If you claimed this dependant on line 5816, enter the amount claimed. 
^
Line 5: Allowable amount for this dependant: line 3 minus line 4 (if 
negative, enter "0") = ^
 
Enter, on line 5820 of Form PE428, the total amount claimed for all 
dependants. 
 
Line 5840 - Caregiver amount 
 
Complete this calculation for each dependant. 
 
Line 1: Base amount 14,399.00 
Line 2: Dependant's net income (line 236 of his or her return) ^
Line 3: Line 1 minus line 2 (if negative, enter "0") (maximum $2,446) = ^
Line 4: If you claimed this dependant on line 5816, enter the amount claimed 
^
Line 5: Allowable amount for this dependant: line 3 minus line 4 (if 
negative, enter "0") = ^ 
 
Enter, on line 5840 of Form PE428, the total amount claimed for all 
dependants. 
 
Line 5844 - Disability amount (for self) 
 
(supplement calculation if you were under 18 years of age on December 31, 
2011) 
 
Line 1: Maximum supplement 4,019.00 
Line 2: Total child care and attendant care expenses for you, claimed by you 
or by another person ^
Line 3: Base amount 2,354.00 
Line 4: Line 2 minus line 3 (if negative, enter "0") = ^
Line 5: Line 1 minus line 4 (if negative, enter "0") = ^
 
Enter, on line 5844 of Form PE428, $6,890 plus the amount from line 5 
(maximum $10,909), unless you are completing this chart to calculate the 
amount at line 5848. 
 
 
5002-D (Back) 
 
Provincial Worksheet (continued) 
 
Line 5848 - Disability amount transferred from a dependant 
 
Complete this calculation for each dependant. 
 
Line 1: Base amount 6,890.00 
Line 2: If the dependant was under 18 years of age on December 31, 2011, 
enter the amount from line 5 of the chart for line 5844 for the dependant. If 
the dependant was 18 years of age or older, enter "0". ^
Line 3: Add lines 1 and 2. = ^
Line 4: Total of amounts your dependant can claim on lines 5804 to 5840 of 
his or her Form PE428 = ^
Line 5: Add lines 3 and 4. = ^
Line 6: Dependant's taxable income (line 260 of his or her return) ^
Line 7: Allowable amount for this dependant: line 5 minus line 6 (if 
negative, enter "0"). Enter, on line 5848 of Form PE428, the amount from line 
3 or line 7, whichever is less. = ^
 
Enter on line 5848 the total amount claimed for all disabled dependants. 
 
If, at the end of the year, you and your dependant were not residents of the 
same province or territory, special rules may apply. Call the Canada Revenue 
Agency to determine the amount you can claim. 
 
Line 5872 - Allowable amount of medical expenses for other dependants 
 
Complete this calculation for each dependant. 
 
Line 1: Medical expenses for other dependant ^
Line 2: Enter $1,678 or 3% of the dependant's net income (line 236 of his or 
her return), whichever is less. ^
Line 3: Line 1 minus line 2 (if negative, enter "0") = ^
 
Enter, on line 5872 of Form PE428, the total amount claimed for all 
dependants. 
 
Line 6152 - Prince Edward Island dividend tax credit 
 
Calculate the amount to enter on line 6152 of Form PE428 by completing one of 
the following two calculations: 
 
- If you entered an amount on line 120 but no amount on line 180 of your 
return, complete the following: 
 
Line 120 of your return ^
Multiplied by 10.5% = ^
Enter the amount on line 6152 of Form PE428. 
 
- If you entered amounts on lines 180 and 120 of your return, complete the 
following: 
 
Line 1: Line 120 of your return ^
Line 2: Line 180 of your return ^
Line 3: Line 1 minus line 2 = ^
Line 4: Line 2 multiplied by 1% = ^
Line 5: Line 3 multiplied by 10.5% = ^
Line 6: Add lines 4 and 5. = ^
Enter the amount on line 6152 of Form PE428. 
 
Line 77 - Prince Edward Island political contribution tax credit 
 
If your total political contributions (line 76 of Form PE428) were $1,150 or 
more, enter $500 on line 77 of Form PE428. 
 
Otherwise, complete the appropriate column depending on the amount on line 
76. 
 
*** Transcriber's Note: Use column 1 if your total contributions are $100 or 
less. Use column 2 if your total contributions are more than $100 but not 
more than $550. Use column 3 if your total contributions are more than $550. 
*** 
 
Column 1: Line 76 is $100 or less 
Line 1: Enter your total contributions. ^
Line 2: 0.00 
Line 3: Line 1 minus line 2. (cannot be negative) = ^
Line 4: Rate 75% 
Line 5: Multiply line 3 by 75% = ^
Line 6: 0.00 
Line 7: Add lines 5 and 6. = ^
Enter the amount on line 77 of Form PE428. 
 
Column 2: Line 76 is more than $100 but not more than $550 
Line 1: Enter your total contributions. ^
Line 2: 100.00 
Line 3: Line 1 minus line 2. (cannot be negative) = ^
Line 4: Rate 50% 
Line 5: Multiply line 3 by 50% = ^
Line 6: 75.00 
Line 7: Add lines 5 and 6. = ^
Enter the amount on line 77 of Form PE428. 
 
Column 3: Line 76 is more than $550 
Line 1: Enter your total contributions. ^ 
Line 2: 550.00 
Line 3: Line 1 minus line 2. (cannot be negative) = ^
Line 4: Rate 33.33% 
Line 5: Multiply line 3 by 33.33% = ^
Line 6: 300.00 
Line 7 Add lines 5 and 6. = ^
Enter the amount on line 77 of Form PE428.