*** Transcriber's Note: Please set your voice synthesizer to read most punctuation. When you encounter the caret sign at the end of a line, please enter the applicable information, necessary. *** Canada Revenue Agency T2121 E (11) (Page 1 of 4) Statement of Fishing Activities For more information on how to complete this form, see Guide T4004, Fishing Income. Identification Your name ^ Your social insurance number (enter 9–digit number) ^ Vessel registration number (VRN) ^ Account Number (15 characters) ^ Boat name ^ City, province or territory ^ Postal code ^ Fiscal period from: (Year/Month/Day) ^ to: (Year/Month/Day) ^ Was 2011 your final year of fishing? Yes or No. ^ Main species ^ Industry code (see Chapter 2 of Guide T4004, Fishing Income) ^ Tax shelter identification number ^ Partnership Business Number (9 digits) ^ Your percentage of the partnership % ^ Name and address of person or firm preparing this form ^ Income Fish products ^ Other marine products ^ Grants, credits, and rebates ^ Subsidies ^ Compensation for loss of fishing income or property ^ Sharesperson income: Name of fishing boat and captain ^ Line 9600: Other income (specify before entering amount) ^ Line a and line 8299: Gross income - Total of the above lines (enter this amount on line 170 of your income tax and benefit return) ^ Net income (loss) before adjustments Line a: Gross income (from line 8299 on page 1) Expenses (enter business part only) Line 9138: Bait, ice, salt ^ Line 9062: Crew shares ^ Line 9224: Fuel and oil costs (except for motor vehicles) ^ Line 9136: Gear ^ Line 8690: Insurance ^ Line 8710: Interest ^ Line 8523: Food ^ Line 8760: Licences ^ Line 9281: Motor vehicle expenses (not including CCA) see Chart A on page 4 ^ Line 8810: Office expenses ^ Line 9137: Nets and traps ^ Line 8860: Legal, accounting, and other professional fees ^ Line 9060: Salaries, wages, and benefits (including employer's contributions) ^ Repairs - Fishing boat ^ - Engine ^ - Electrical equipment ^ Total of the above three lines ^ Minus Insurance recovery ^ Line 8963: Your cost ^ Line 9270: Other expenses ^ Subtotal ^ Line 9935: Allowance on eligible capital property ^ Line 9936: Capital cost allowance (from Area A on page 3) ^ Line b and line 9368: Total expenses (total of the above three lines) ^ Line 9369: Net income (loss) before adjustments (line a minus line b) ^ T2121 E (11) Page 2 of 4) Your net income (loss) Line c: Your share of line 9369 on page 1 Line 9974: Plus: GST/HST rebate for partners received in the year ^ Line d: Total (line c plus line 9974) ^ Line e and line 9943: Minus: Other amounts deductible from your share of net partnership income (loss) (from the chart below) ^ Line f: Net income (loss) after adjustments (line d minus line e) ^ Line 9945: Minus: Business-use-of-home expenses (your share of line 3 from the chart below) ^ Line 9946: Your net income (loss) (line f minus line 9945) (enter this amount on line 143 of your income tax and benefit return) ^ Other amounts deductible from your share of net partnership income (loss) *** Transcriber's Note: Enter as many lines as necessary for the following *** Claim expenses you incurred that were not included in the partnership statement of income and expenses, and for which the partnership did not reimburse you. Line: ^ Total (enter this amount on line e above) ^ Calculating business-use-of-home expenses Heat ^ Electricity ^ Insurance ^ Maintenance ^ Mortgage interest ^ Property taxes ^ Other expenses (specify) ^ Subtotal ^ Minus: Personal-use part ^ Subtotal ^ Plus: Capital cost allowance (business part only) ^ Amount carried forward from previous year ^ Line 1: Subtotal ^ Line 2: Minus: Net income (loss) after adjustments (from line f above) (if negative, enter "0") ^ Business-use-of-home expenses available to carry forward (line 1 minus line 2) (if negative, enter "0") ^ Line 3: Allowable claim (the lesser of amounts 1 or 2 above) (enter this amount on line 9945 above) ^ Details of other partners Name and address ^ Share of net income or (loss) $ ^ Percentage of partnership % ^ Name and address ^ Share of net income or (loss) $ ^ Percentage of partnership % ^ Name and address ^ Share of net income or (loss) $ ^ Percentage of partnership % ^ Details of equity Line 9931: Total business liabilities ^ Line 9932: Drawings in 2011 ^ Line 9933: Capital contributions in 2011 ^ T2121 E (11) (Page 3 of 4) *** Transcriber's Note: In print, Area A is set-up as 10 columns with 3 entry lines for each column. Enter as many lines as necessary. *** Area A – Calculating capital cost allowance (CCA) Column 1: Class number ^ Column 2: Undepreciated capital cost (UCC) at the start of the year ^ Column 3: Cost of additions in the year (see Areas B and C below) ^ Column 4: Proceeds of dispositions in the year (see Areas D and E below) ^ Column 5*: UCC after additions and dispositions (column 2 plus column 3 minus column 4) ^ Column 6: Adjustment for current-year additions one-half multiplied by (column 3 minus column 4) If negative, enter "0" ^ Column 7: Base amount for CCA (column 5 minus column 6) ^ Column 8: Rate (%) ^ Column 9: CCA for the year (column 7 multiplied by column 8 or an adjusted amount) ^ Column 10: UCC at the end of the year (column 5 minus column 9) ^ Line i: Total CCA on Part XI properties (enter on line 9936 on page 1 the "business" part of this amount minus any CCA for business-use-of-home expenses**)(add all the amount in column 9) ^ * If you have a negative amount in this column, add it to income as a recapture under "Other income" on the appropriate line on page 1. If there is no property left in the class and there is a positive amount in the column, deduct the amount from income as a terminal loss on line 9270, "Other expenses," on page 2. Recapture and terminal loss do not apply to a Class 10.1 property. For more information, read Chapter 3 of Guide T4004, Fishing Income. ** For information on CCA for business-use-of-home expenses, see "Special situations", Chapter 3 of Guide T4004, Fishing Income. Enter the total of line i on line 9936, on page 1. Area B – Details of equipment additions in the year Line 1: Column 1: Class number ^ Column 2: Property description ^ Column 3: Total cost ^ Column 4: Personal part (if applicable) ^ Column 5: Business part (column 3 minus column 4) ^ Line 2: Column 1: Class number ^ Column 2: Property description ^ Column 3: Total cost ^ Column 4: Personal part (if applicable) ^ Column 5: Business part (column 3 minus column 4) ^ Line 9925: Total equipment additions in the year (add all the amounts in column 5) ^ Area C - Details of building additions in the year Line 1: Column 1: Class number ^ Column 2: Property description ^ Column 3: Total cost ^ Column 4: Personal part (if applicable) ^ Column 5: Business part (column 3 minus column 4) ^ Line 2: Column 1: Class number ^ Column 2: Property description ^ Column 3: Total cost ^ Column 4: Personal part (if applicable) ^ Column 5: Business part (column 3 minus column 4) ^ Line 9927: Total building additions in the year (add all the amounts in column 5) ^ Area D - Details of equipment dispositions in the year Line 1: Column 1: Class number ^ Column 2: Property description ^ Column 3: Proceeds of disposition (should not be more than the capital cost) ^ Column 4: Personal part (if applicable) ^ Column 5: Business part (column 3 minus column 4) ^ Line 2: Column 1: Class number ^ Column 2: Property description ^ Column 3: Proceeds of disposition (should not be more than the capital cost) ^ Column 4: Personal part (if applicable) ^ Column 5: Business part (column 3 minus column 4) ^ Line 9926: Total equipment dispositions in the year (add all the amounts in column 5) ^ Note: If you disposed of property from your fishing business in the year, see Chapter 3 of Guide T4004, Fishing Income, for information about your proceeds of disposition. Area E - Details of building dispositions in the year Line 1: Column 1: Class number ^ Column 2: Property description ^ Column 3: Proceeds of disposition (should not be more than the capital cost) ^ Column 4: Personal part (if applicable) ^ Column 5: Business part (column 3 minus column 4) ^ Line 2: Column 1: Class number ^ Column 2: Property description ^ Column 3: Proceeds of disposition (should not be more than the capital cost) ^ Column 4: Personal part (if applicable) ^ Column 5: Business part (column 3 minus column 4) ^ Line 9928: Total building dispositions in the year (add all the amounts in column 5) ^ Note: If you disposed of property from your fishing business in the year, see Chapter 3 of Guide T4004, Fishing Income, for information about your proceeds of disposition. Area F - Details of land additions and dispositions in the year Line 9923: Total cost of all land additions in the year ^ Line 9924: Total proceeds from all land dispositions in the year ^ Note: You cannot claim capital cost allowance on land. T2121 E (11) (Page 4 of 4) Chart A – Motor vehicle expenses Line 1: Enter the kilometres you drove in the tax year to earn fishing income ^ Line 2: Enter the total kilometres you drove in the tax year ^ Line 3: Fuel and oil ^ Line 4: Interest (see Chart B below) ^ Line 5: Insurance ^ Line 6: Licence and registration ^ Line 7: Maintenance and repairs ^ Line 8: Leasing (see Chart C below) ^ Line 9: Other expenses (please specify) ^ Line 10: Other expenses (please specify) ^ Line 11: Total motor vehicle expenses: Add lines 3 to 10 ^ Line 12: Business-use part: (line 1: ^ divided by line 2: ^ ) multiplied by line 11: ^ = ^ Line 13: Business parking fees ^ Line 14: Supplementary business insurance ^ Allowable motor vehicle expenses (add lines 12, 13, and 14) (enter this amount on line 9281 on page 1) ^ Note: You can claim CCA on motor vehicles in Area A, on page 3. Chart B – Available interest expense for passenger vehicles Line A: Total interest payable (accrual method) or paid (cash method) in the fiscal period ^ Line B: $10* multiplied by the number of days in the fiscal period for which interest was payable (accrual method) or paid (cash method) = ^ Available interest expense: Amount A or B, whichever is less (enter this amount on line 4 of Chart A) ^ * For passenger vehicles bought after 2000. Chart C – Eligible leasing cost for passenger vehicles Line 1: Total lease charges incurred in your 2011 fiscal period for the vehicle ^ Line 2: Total lease payments deducted before your 2011 fiscal period for the vehicle ^ Line 3: Total number of days the vehicle was leased in your 2011 fiscal period and previous fiscal periods ^ Line 4: Manufacturer's list price ^ Line 5: The amount on line 4 or [$35,294 (GST and PST, or HST* on $35,294)], whichever is more multiplied by 85%= ^ Line 6: [($800 plus GST and PST, or HST* on $800) multiplied by line 3 divided by 30] minus line 2: ^ Line 7: [($30,000 GST and PST, or HST* on $30,000) multiplied by line 1] divided by line 5 = ^ Eligible leasing cost: Line 6 or 7, whichever is less (enter this amount on line 8 of Chart A above) * Use a GST rate of 5% or HST rate applicable to your province. Privacy Act, Personal Information Bank number CRA PPU 005