5009-D (Page 1 of 3) 2011 T1 General Government of Alberta Provincial Worksheet Use these charts to do some of the calculations you may need to complete Form AB428, Alberta 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 4,731.00 Line 2: Your net income from line 236 of your return ^ Line 3: Base amount 35,217.00 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 AB428. Line 5820 - Amount for infirm dependants age 18 or older Complete this calculation for each dependant. Line 1: Base amount 16,319.00 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 $9,827) = ^ 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 AB428, the total amount claimed for all dependants. Line 5840 - Caregiver amount Complete this calculation for each dependant. Line 1: Base amount 25,452.00 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 $9,827) = ^ 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 AB428, 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 9,827.00 Line 2: Total of child care and attendant care expenses for you, claimed by you or by another person ^ Line 3: Base amount 2,680.00 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 AB428, $13,095 plus the amount from line 5 (maximum $22,922), unless you are completing this chart to calculate the amount at line 5848. 5009-D (Page 2 of 3) Provincial Worksheet (continued) Line 5848 - Disability amount transferred from a dependant Complete this calculation for each dependant. Line 1: Base amount 13,095.00 Line 2: If the dependant was under 18 years of age on December 31, 2011, enter the amount from line 5 of the calculation 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 AB428 ^ 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 AB428, the amount on line 3 or line 7, whichever is less. = ^ Enter, on line 5848 of Form AB428, 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 $2,194 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 AB428, the total amount claimed for all other dependants. Line 5896 - Donations and gifts Line 1: Amount from line 345 of your federal Schedule 9 ^ Line 2: Line 1 multiplied by 10% = ^ Line 3: Amount of donations and gifts from line 5895 of Form AB428 ^ Line 4: Enter the amount from line 1 or line 3, whichever is less. ^ Line 5: Line 3 minus line 4 = ^ Line 6: Line 5 multiplied by 12.75% = ^ Line 7: Amount from line 347 of your federal Schedule 9 ^ Line 8: Amount from line 5 ^ Line 9: Line 7 minus line 8. = ^ Line 10: Line 9 multiplied by 21% = ^ Line 11: Add lines 2, 6, and 10. = Enter this amount on line 5896 of Form AB428. 5009-D (Page 3 of 3) Provincial Worksheet (continued) Line 6152 - Alberta dividend tax credit Calculate the amount to enter on line 6152 of Form AB428 by completing one of the two following 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% = Enter this amount on line 6152 of Form AB428. – 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 3.5% = ^ Line 5: Line 3 multiplied by 10% = ^ Line 6: Add lines 4 and 5. = ^ Enter this amount on line 6152 of Form AB428. Lines 45 and 47 - Alberta political contribution tax credit Complete this calculation for each type of Alberta political contribution. If your total political contributions (line 44 or 46 of Form AB428) were $2,300 or more, enter $1,000 on line 45 or 47 (as applicable) of Form AB428. Otherwise, complete the appropriate column depending on the amounts on lines 44 and 46. *** Transcriber's Note: Use column 1 if your total contributions are $200 or less. Use column 2 if your total contributions are more than $200 but not more than $1,100. Use column 3 if your total contributions are more than $1,100. *** Column 1: Line 44 or 46 is $200 or less Line 1: Enter the amount of your 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. = ^ Column 2: Line 44 or 46 is more than $200 but not more than $1,100 Line 1: Enter the amount of your contributions. ^ Line 2: 200.00 Line 3: Line 1 minus line 2 (cannot be negative) = ^ Line 4: Rate 50% Line 5: Multiply line 3 by 50%. = ^ Line 6: 150.00 Line 7: Add lines 5 and 6. = ^ Column 3: Line 44 or 46 is more than $1,100 Line 1: Enter the amount of your contributions. ^ Line 2: 1,100.00 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: 600.00 Line 7: Add lines 5 and 6. = ^ Enter the result from line 7 on: – line 45 of Form AB428 for your contributions from your receipt called Annual Contribution; or – line 47 of Form AB428 for your contributions from your receipt called Senatorial Selection Campaign Contribution.