NR4 Summary - Summary of Amounts Paid or Credited to Non-Residents of Canada

NR4 Summary details

For the year ending December 31

YYYY

or

Estates and trusts fiscal year end

YYYY
MM
DD

Non-resident account number

Code box 1
 

IMPORTANT
The payer or agent's name and account number must match the ones shown on your Form NR76, Non-Resident Tax � Statement of Account.

Name and address of payer or agent

Last Name

 

First Name

 

Initial

 

Street Address

 

Street Address

 

City

 

Province

 

Country

 

Postal Code (A1A1A1)

 

Total number of NR4 Slips filed

Code box 88
 

NR4 slips totals

Gross Income

Amounts reported on NR4 slips

Code box 18
 

Amounts reported on form NR601 or NR602

Code box 26
 

Total (18 + 26)

Code box 30
 

Tax Withheld

Amounts reported on NR4 slips

Code box 22
 

Amounts reported on form NR601 or NR602

Code box 28
 

Total non-resident tax withheld (22 + 28)

Code box 32
 

Minus total remittances for the year

Code box 82
 

Difference - Generally, we do not charge or refund a difference of $2 or less.

 

Overpayment

Code box 84
 

Balance due

Code box 86
 

Person to contact about this return

Name

Code box 76
 

Telephone number

Code box 78
 

Extension

 

Certification

I certify that the information given in this NR4 return (NR4 Summary and related NR4 slips) is, to the best of my knowledge, correct and complete.

Date

 

Signature of authorized person

 

Position or office

 
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