*** 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, if necessary. *** T2200 E (11) (Front) Canada Revenue Agency DECLARATION OF CONDITIONS OF EMPLOYMENT The employer must complete this form for the employee to deduct employment expenses from his or her income. The employee does not have to file this form with his or her return, but must keep it in case we ask to see it. For details about claiming employment expenses, see Guide T4044, Employment Expenses, or interpretation bulletins IT-352, Employee's Expenses, Including Work Space in Home Expenses, and IT- 522, Vehicle, Travel and Sales Expenses of Employees. Part A - Employee information (please print) Last name ^ First name ^ Tax year ^ Social Insurance Number (enter 9 digit number) ^ Home address ^ Business address ^ Job title and brief description of duties ^ Part B – Conditions of employment 1. Did this employee's contract require him or her to pay his or her own expenses while carrying out the duties of employment? Yes or No ^ Answer "yes" or No even if you provide an allowance or a reimbursement in respect of some or all such expenses. If no, the employee is not entitled to claim employment expenses, and you are not required to answer any of the other questions. 2. Did you normally require this employee to work away from your place of business or in different places? Yes or No ^ If yes, what was the employee's area of travel (be specific)? ^ 3. Did you require this employee to be away for at least 12 consecutive hours from the municipality and metropolitan area (if there is one) of your business where the employee normally reported for work? Yes or No ^ If yes, how frequently? ^ 4. Indicate the period(s) of employment during the year: From Year/Month/Day ^ to Year/Month/Day ^ If there was a break in employment, specify dates: ^ 5. Did this employee receive a motor vehicle allowance? Yes or No ^ If yes, indicate: - the amount received as a fixed allowance, such as a flat monthly allowance $^ - the per kilometres rate used ^ ($ per kilometres), and the amount received $^ - the amount of the allowance that was included on the employee's T4 slip $^ Did this employee have the use of a company vehicle? Yes or No ^ Was the employee responsible for any of the expenses incurred for the company vehicle? Yes or No ^ If yes, indicate the amount and type of expenses: Amount $^ Type of expenses ^ Amount $^ Type of expenses ^ Amount $^ Type of expenses ^ 6. Did you require this employee to pay for expenses for which he or she did or will receive a repayment? Yes or No ^ If yes, indicate the amount and type of expenses that were: - received upon proof of payment Amount $^ Type of expenses ^ Included on T4 slip Yes or No ^ - charged to the employer, such as credit card charges Amount $^ Type of expenses ^ Included on T4 slip Yes or No ^ 7. Did you require this employee to pay other expenses for which he or she did not receive any allowance or repayment? Yes or No ^ If yes, indicate the type(s) of expenses: ^ T2200 E (11) Back 8. Did you pay this employee wholly or partly by commission according to the volume of sales made or contracts negotiated? Yes or No ^ If yes, indicate the commissions paid ($^ ) and the type of goods sold or contracts negotiated ^ Is there a business development account or other similar commission income account available from which the employee's employment expenses are paid or reimbursed? Yes or No ^ If yes, is the commission income from this account included in box 14 of the T4 slip? Yes or No ^ 9. Did this employee's contract of employment require him or her to: - rent an office away from your place of business? Yes or No ^ - pay for a substitute or assistant? Yes or No ^ - pay for supplies that the employee used directly in his or her work? Yes or No ^ - pay for the use of a cell phone? Yes or No ^ Did you or will you reimburse this employee for any of these expenses? Yes or No ^ If yes, indicate the type of expense and amount you did or will reimburse: Amount $^ Type of expense ^ Included on T4 slip Yes or No ^ Amount $^ Type of expense ^ Included on T4 slip Yes or No ^ Amount $ Type of expense ^ Included on T4 slip Yes or No ^ 10 Did this employee's contract of employment require him or her to use a portion of his or her home for work? Yes or No ^ If yes, approximately what percentage of the employee's duties of employment were performed at their home office? (%) ^ Was the home office used exclusively to earn income from the office or employment, and on a regular and continuous basis for meeting clients or other persons in the ordinary course of performing the office or employment duties during the period to which the expenses relate? Yes or No ^ Did you or will you reimburse this employee for any of his or her home office expenses? Yes or No ^ If yes, indicate the type of expense and amount you did or will reimburse: Amount $^ Type of expense ^ Included on T4 slip Yes or No ^ Amount $^ Type of expense ^ Included on T4 slip Yes or No ^ Amount $^ Type of expense ^ Included on T4 slip Yes or No ^ 11 Did this employee work for you as a tradesperson? Yes or No ^ If yes, did you require this employee, as a condition of employment, to purchase and provide tools that were used directly in his or her work? Yes or No ^ If yes, do all of the tools itemized on the list provided to you by the employee satisfy this condition? Yes or No ^ Please sign and date the list. 12. Did this employee work for you as an apprentice mechanic? Yes or No ^ If yes, was this employee registered in a program established under the laws of Canada or of a province or territory that leads to a designation under those laws as a mechanic licensed to repair self-propelled motorized vehicles? Yes or No ^ Did you require this apprentice mechanic, as a condition of employment, to purchase and provide tools that were used directly in his or her work? Yes or No ^ If yes, are all of the tools itemized on the list provided to you by the employee used in connection with the employee's work for you as an apprentice mechanic in the program described in this question? Yes or No ^ Please sign and date the list. 13.Did this employee work for you in forestry operations? Yes or No ^ Did this employee, as a condition of employment, have to provide a power saw (including a chain saw or tree trimmer)? Yes or No ^ Employer declaration I certify that the information provided on this form is, to the best of my knowledge, correct and complete. Name of employer (print) ^ Date ^ Telephone Number ^ Name and title of authorized person (print) ^ Signature of employer or authorized person ^ Note: Please make sure that the name and telephone number of the authorized person are clearly printed in case we need to call to verify information. Privacy Act, Personal Information Bank number CRA PPU 005