5012-C (Front) T1 General - 2011 NT428 Northwest Territories Tax Complete this form, and attach a copy to your return. For more information, see the related line in the forms book. Step 1 - Northwest Territories non-refundable tax credits Line 5610: For internal use only Line 1 and 5804: Basic personal amount claim $12,919 ^ Line 2 and 5808: Age amount (if born in 1946 or earlier)(use territorial worksheet) (maximum $6,319) ^ Spouse or common-law partner amount Base amount 12,919.00 Minus: his or her net income from page 1 of your return ^ Line 3 and line 5812 Result: (if negative, enter "0") = ^ Amount for an eligible dependant Base amount 12,919.00 Minus: his or her net income from line 236 of his or her return = ^ Line 4 and line 5816: Result: (if negative, enter "0") = ^ Line 5 and line 5820: Amount for infirm dependants age 18 or older (use territorial worksheet) ^ CPP or QPP contributions: Line 6 and line 5824: (amount from line 308 of your federal Schedule 1) ^ Line 7 and line 5828: (amount from line 310 of your federal Schedule 1) ^ Employment Insurance premiums: Line 8 and line 5832: (amount from line 312 of your federal Schedule 1) ^ Line 9 and line 5829: (amount from line 317 of your federal Schedule 1) ^ Line 10 and line 5836: Pension income amount (maximum $1,000) ^ Line 11 and line 5840: Caregiver amount (use territorial worksheet) ^ Line 12 and line 5844: Disability amount (for self) ^ Line 13 and line 5848: Disability amount transferred from a dependant (use territorial worksheet) ^ Line 14 and line 5852: Interest paid on your student loans (amount from line 319 of your federal Schedule 1) ^ Line 15 and line 5856: Your tuition and education amounts [attach Schedule NT(S11)] ^ Line 16 and line 5860: Tuition and education amounts transferred from a child ^ Line 17 and line 5864: Amounts transferred from your spouse or common-law partner [attach Schedule NT(S2)] ^ Medical expenses: Line 18 and line 5868: Amount from line 330 of your federal Schedule 1 ^ Line 19: Enter $2,052 or 3% of net income from line 236 of your return whichever is less. ^ Line 20: Line 18 minus line 19 (if negative, enter "0") = ^ Line 21 and line 5872: Allowable amount of medical expenses for other dependants (use territorial worksheet) ^ Line 22 and line 5876: Add lines 20 and 21. = ^ Line 23 and line 5880: Add lines 1 through 17, and line 22. = ^ Line 24: Northwest Territories non-refundable tax credit rate 5.9% Line 25 and line 5884: Multiply line 23 by line 24. = ^ Donations and gifts: Line 26: Amount from line 345 of your federal Schedule 9 ^ multiplied by 5.9% = ^ Line 27: Amount from line 347 of your federal Schedule 9 ^ multiplied by 14.05% = ^ Line 28 and line 5896: Add lines 26 and 27. = ^ Line 29 and line 6150: Add lines 25 and 28. Enter this amount on line 41. Northwest Territories non-refundable tax credits = ^ Go to Step 2 on the next page. 5012-C (Back) Step 2 - Northwest Territories tax on taxable income Line 30: Enter your taxable income from line 260 of your return. ^ Complete the appropriate column depending on the amount on line 30. *** Transcriber's Note: Use column 1 if the amount on line 30 is $37,626 or less. Use column 2 if the amount on line 30 is more than $37,626, but not more than $75,253. Use column 3 if the amount on line 30 is more than $75,253, but not more than $122,345. Use column 4 if the amount on line 30 is more than $122,345. *** Column 1 Line 30 is $37,626 or less Line 31: Enter the amount from line 30 ^ Line 32: 0.00 Line 33: Line 31 minus line 32 (cannot be negative) = ^ Line 34: Rate 5.9% Line 35: Multiply line 33 by 5.9%. = ^ Line 36: 0.00 Line 37: Add lines 35 and 36. Northwest Territories tax on taxable income = ^ Go to Step 3 Column 2 Line 30 is more than $37,626 but not more than $75,253 Line 31: Enter the amount from line 30 ^ Line 32: 37,626.00 Line 33: Line 31 minus line 32 (cannot be negative) = ^ Line 34: Rate 8.6% Line 35: Multiply line 33 by 8.6% = ^ Line 36: 2,220.00 Line 37: Add lines 35 and 36. Northwest Territories tax on taxable income = ^ Go to Step 3 Column 3 Line 30 is more than $75,253 but not more than $122,345 Line 31: Enter the amount from line 30 ^ Line 32: 75,253.00 Line 33: Line 31 minus line 32 (cannot be negative) = ^ Line 34: Rate 12.2% Line 35: Multiply line 33 by 12.2% = ^ Line 36: 5,456.00 Line 37: Add lines 35 and 36. Northwest Territories tax on taxable income = ^ Go to Step 3 Column 4 Line 30 is more than $122,345 Line 31: Enter the amount from line 30 ^ Line 32: 122,345.00 Line 33: Line 31 minus line 32 (cannot be negative) = ^ Line 34: Rate 14.05% Line 35: Multiply line 33 by 14.05%. = ^ Line 36: 11,201.00 Line 37: Add lines 35 and 36. Northwest Territories tax on taxable income = ^ Go to Step 3 Step 3 - Northwest Territories tax Line 38: Enter your Northwest Territories tax on taxable income from line 37. ^ Line 39 and line 6151: Enter your Northwest Territories tax on split income from Form T1206. ^ Line 40: Add lines 38 and 39. = ^ Line 41: Enter your Northwest Territories non-refundable tax credits from line 29. ^ Line 42 and line 6152: Northwest Territories dividend tax credit: Credit calculated for line on the Territorial Worksheet ^ Northwest Territories overseas employment tax credit: Line 43 and line 6153: Amount from line 426 on your federal Schedule 1 ^ multiplied by 45% = ^ Northwest Territories minimum tax carryover: Line 44 and line 6154: Amount from line 427 on your federal Schedule 1 ^ multiplied by 45% = ^ Line 45: Add lines 41 through 44. = ^ Line 46: Line 40 minus line 45 (if negative, enter "0") = ^ Northwest Territories additional tax for minimum tax purposes: Line 47: Amount from line 117 of Form T691 ^ multiplied by 45% = ^ Line 48: Add lines 46 and 47. = ^ Line 49: Enter the territorial foreign tax credit from Form T2036. ^ Line 50: Line 48 minus line 49 (if negative enter "0") = ^ Political contribution tax credit Line 51 and line 6255: Northwest Territories political contributions made in 2011 ^ Line 52: Credit calculated for line 52 on the Territorial Worksheet (maximum $500) ^ Line 53: Line 50 minus line 52 (if negative, enter "0") = ^ Risk capital investment tax credits Line 54: Unused risk capital investment tax credits from previous years (maximum $30,000) ^ Line 55: Line 53 minus 54 (if negative, enter "0") Northwest Territories tax = ^ Enter the result on line 428 of your return. 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