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T1036 E (09) 
 
Canada Revenue Agency 
 
HOME BUYERS' PLAN (HBP) REQUEST TO WITHDRAW FUNDS FROM AN RRSP 
 
Use this form to make a withdrawal from your registered retirement savings 
plan (RRSP) under the Home Buyers' Plan (HBP). Answer the questions in Part A 
of Area 1 to determine if you are eligible to make a withdrawal from your 
RRSP under the HBP. Although some conditions may apply to another person in 
certain situations, you (the participant) are responsible for making sure 
that all the conditions are met. For more details about the HBP, see Guide 
RC4135, Home Buyers' Plan (HBP). Generally, you must receive all your HBP 
withdrawals in the same calendar year and the maximum you can withdraw is 
$25,000. Complete Area 1 and give the form to your financial institution. 
 
Area 1 - To be completed by the participant 
 
Part A - Complete the following questionnaire to determine if you can make a 
withdrawal from your RRSP under the HBP. 
 
1. Are you a resident of Canada? Yes or No. ^
If Yes Go to question 2. If No You cannot make an HBP withdrawal. 
 
2. Has the person who is buying or building a qualifying home entered into a 
written agreement to do so? Yes or No. ^
If Yes Go to question 3(a). If No You cannot make an HBP withdrawal. 
 
3(a). Have you ever, before this year, withdrawn funds from your RRSP under 
the HBP to buy or build a qualifying home? Yes or No. ^
If Yes Go to question 3(b). If No Go to question 4(a). 
 
3(b). Are you making this request in January as part of the participation you 
began last year? Yes or No. ^
If Yes Go to question 4(a). If No Go to question 3(c). 
 
3(c). Was your repayable balance from your previous HBP participation zero on 
January 1 of this year? Yes or No. ^
If Yes Go to question 4(a). If No You cannot make an HBP withdrawal. 
 
4(a). Are you a person with a disability? Yes or No. ^
If Yes Go to question 5. If No Go to question 4(b). 
 
4(b). Are you withdrawing funds from your RRSP to buy or build a qualifying 
home for a related person with a disability or to help such a person buy or 
build a qualifying home? Yes or No. ^
If Yes Go to question 5. If No Go to question 4(c). 
 
4(c). Are you considered a first-time home buyer? Yes or No. ^
If Yes Go to question 5. If No You cannot make an HBP withdrawal. 
 
5. Does the person who is buying or building the qualifying home intend to 
occupy it as his or her principal place of residence no later than one year 
after buying or building it? If you are acquiring the home for a related 
person with a disability or helping a related person with a disability 
acquire the home, you must intend that the related person with a disability 
occupy the home as his or her principal place of residence. Yes or No. ^
If Yes Go to question 6. If No You cannot make an HBP withdrawal. 
 
6. Has the person who is buying or building the qualifying home or his or her 
spouse or common-law partner owned the home more than 30 days before 
receiving this withdrawal? Yes or No. ^
If Yes You cannot make an HBP withdrawal. If No You are eligible (complete 
Part B). 
 
Part B - Complete this part to make a withdrawal from your RRSP under the 
HBP. 
 
First name and initials ^
Last name ^
 
Social insurance number (SIN) (enter 9-digit number) ^
 
Address of qualifying home being bought or built (include number, street, 
rural route, or lot and concession number) ^
City ^
Province or Territory ^
Postal code ^
 
Telephone number (including area code) ^
 
If you are a person with a disability, check this box (enter an "X"). ^
 
If you answered "Yes" to question 4(b) above, provide the following 
information about that person: 
 
Person's name ^
Relationship to you ^
Person with a disability's SIN (enter 9-digit number) ^
 
Part C - Certification 
 
Amount of requested withdrawal $^
Date withdrawal required (Year/Month/Day) ^
 
I certify that the information given in Area 1 of this form is correct. 
 
Participant's signature ^
Date (Year/Month/Day) ^
Account number of the RRSP from which the withdrawal is made ^
 
Area 2 - To be completed by the RRSP issuer (Do not send this form to the 
CRA. Keep it for your records.) 
 
Issuer's name ^
Issuer's address ^
Telephone number (including area code) ^
 
Amount paid (maximum $25,000) for 2009 or a later year for withdrawals made 
after January 27, 2009 $^
Date withdrawal paid (Year/Month/Day) ^
 
Privacy Act Personal Information Bank number CRA/P-PU-005