*** 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. *** T3 RET E (11) (Page 1 of 4) Canada Revenue Agency T3 TRUST INCOME TAX AND INFORMATION RETURN Legislative references on this return refer to the Income Tax Act and Income Tax Regulations. All references to "the guide" on this return refer to Publication T4013, T3 Trust Guide. 2011 Do not use this area \\ Step 1 - Identification and other required information Residence of trust at the end of the tax year Specify country (if other than Canada) ^ If Canada, enter the province or territory ^ Name of trust ^ Trust account number T (Enter 8 digit number) ^ Name of trustee, executor, liquidator, or administrator ^ Do not use this area Mailing address of trustee, executor, liquidator, or administrator ^ Postal code ^ Telephone number (including area code) ^ Mailing address, if different than trustee (or name and mailing address of the contact person, if different) ^ Postal code ^ Telephone number (including area code) ^ Is the trust resident on designated Aboriginal settlement lands? No or Yes ^ If yes, enter the name and settlement number. (Enter 5 digit number) ^ If the trust had business income in the year, enter the province(s) or territory(ies) where that income was earned. If the trust became or ceased to be a resident of Canada in the year, enter the date. Became resident (Year/Month/Day) ^ Ceased to be resident (Year/Month/Day) ^ Type of Trust Testamentary (enter an "x" to the applicable) Spousal or common-law partner ^ Other ^ Date of death (Year/Month/Day) ^ Social insurance number of deceased ^ Inter vivos (enter an "x" to the applicable) Spousal or common-law partner ^ Unit ^ Mutual fund ^ Communal organization ^ Employee benefit plan ^ SIFT (specified investment flow-through trust) ^ TFSA (tax-free savings account) ^ Insurance segregated fund: Fully or partially registered ^ Non-registered ^ Date trust was created (Year/Month/Day) ^ Non-profit organization - Business Number: ^ (Enter 15 digit number) ^ Employee ^ Personal ^ Joint spousal or common-law partner ^ Alter ego ^ Employee Life and Health ^ Code number for other inter vivos, see the guide for details. (enter 3 digit number) ^ Other inter vivos (specify) ^ Deemed resident Is this a deemed resident trust? Yes ^ If yes, please specify any other country in which it is also considered resident. ^ Return for tax year From (Year/Month/Day) ^ to (Year/Month/Day) ^ Is this the first year of filing a T3 return? No or Yes ^ If no, for what year was the last return filed? Year ^ If yes, attach a copy of the trust document or will, and a list of assets at death (unless filed with the deceased's final T1 return). Attached or With T1 ^ Is this an amended return? No or Yes ^ Address on last return is same as above, or the following: ^ Same ^ Is this the final return of the trust? No or Yes ^ If yes, enter the trust wind-up date. (Year/Month/Day) ^ Your language of correspondence: English ^ French ^ T3 RET (11) (Page 2 of 4) Other required information Line 1: Is the trust one of a number of trusts created from contributions by the same individual? If yes, complete Schedule 6, and attach a list of the names, addresses, and account numbers of the other trusts. No or Yes ^ Line 2: For any trust (other than a unit trust), did the ownership of capital or income interests change since 1984? No or Yes ^ If yes, enter the year, and, if during this tax year, attach a statement showing the changes. Year ^ Line 3: Were the terms of the trust amended or varied since June 18, 1971? No or Yes ^ If yes, enter the year, and, if during this tax year, attach copies of the documents effecting these changes. Year ^ Line 4: Has the trust continuously resided in Canada since it was established (or since June 18, 1971, if it was established before that date)? No or Yes ^ Line 5: Did the trust receive any additional capital property by way of gift since June 18, 1971? (Do not include the original property settled on the trust.) No or Yes ^ If yes, enter the year, and, if during this tax year, attach a statement giving the details. Year ^ Line 6: Did the trust borrow money, or incur a debt, in a non-arm's length transaction since June 18, 1971? No or Yes ^ If yes, state the year, and, if during this tax year, attach a statement showing the amount of the loan, the lender's name, and the lender's relationship to the beneficiaries. Year ^ Line 7: Does the will, trust document, or court order require the payment to beneficiaries of trust income earned in the current year? No or Yes ^ If yes, complete Schedule 9. Line 8: Did the trust receive, after December 17, 1999, any property as a transfer from a non-grandfathered, inter vivos trust, where the beneficial ownership of the property did not change as a result of the transfer? No or Yes ^ If yes, enter the year, and, if during this tax year, attach a statement giving details. Year ^ Line 9: Did the trust distribute assets other than cash to a beneficiary during the tax year? Yes or No ^ If yes, attach a statement giving a complete description of the property, the name and address of the beneficiary to whom the property was distributed, and the date the property was distributed. If the beneficiary is an individual, provide the beneficiary's social insurance number. Line 10: Did the trust receive any additional property by way of a contribution of property (as defined in the "Definitions" of the guide) since June 22, 2000? No or Yes ^ If yes, enter the year, and, if during this tax year, attach a statement giving details. Year ^ Line 11: Does the trust qualify as a public trust or public investment trust that has to post information about the trust on the CDS Innovations Inc Web site under section 204.1 of the Income Tax Regulations? No or Yes ^ Line 12: Did the trust use the International Financial Reporting Standards when it prepared its financial statements? No or Yes ^ Step 2 - Calculating total income (see lines 01 to 20 in the guide) Line 01: Taxable capital gains (line 21 of Schedule 1) ^ \\ Line 02: Pension income (report CPP/QPP death benefits on line 19 below) ^ \\ Line 03: Total of actual amount of dividends from taxable Canadian corporations (line 3 of Schedule 8) ^ Line 3A: Actual amount of dividends other than eligible dividends from taxable Canadian corporations (line 1 of Schedule 8) ^ \\ Line 04: Foreign investment income (line 6 of Schedule 8) ^ \\ Line 05: Other investment income (line 12 of Schedule 8) ^ Line 06: Business income Line 96: Gross ^ Net ^ Line 07: Farming income Line 97: Gross ^ Net ^ Line 08: Fishing income Line 98: Gross ^ Net ^ Line 09: Rental income Line 99: Gross ^ Net ^ Line 10: NISA Fund 2 ^ Line 101: (includes ^ NISA Fund 2 payments received while the beneficiary spouse or common-law partner is, or was, alive, or received by a communal organization) Line 11: Deemed dispositions income or losses (line 42 of Form T1055) ^ \\ Line 19 Other income (specify and attach any information slips received) = ^ \\ Line 20: Add lines 01 to 19. This is the trust's total income. = ^ T3 RET (11) (Page 3 of 4) Step 3 - Calculating net income (see lines 21 to 50 in the guide) Line 20: Trust's total income (line 20 of page 2) ^ \\ Line 21: Carrying charges and interest expenses (line 17 of Schedule 8) ^ Line 22: Trustee fees (see lines 22 to 24 in the guide) ^ Line 23: Trustee fees that do not relate to income or were deducted elsewhere on this return ^ Line 24: Trustee fees deductible from income (line 22 minus line 23) = ^ Line 25: Allowable business investment losses ^ Line 40: Other deductions from total income (specify-see line 40 in the guide) = ^ \\ Line 41: Add lines 21, 24, 25, and 40 = ^ \\ Line 42: Line 20 minus line 41 = ^ Taxable benefits (see lines 43 and 44 in the guide) Line 43: Upkeep, maintenance, and taxes of a property used or occupied by a beneficiary ^ Line 44: Value of other benefits to a beneficiary ^ Line 45: Total taxable benefits (line 43 plus line 44) = ^ \\ Line 46: Income before allocations (line 42 plus line 45) = ^ Line 471: Amounts paid or payable to beneficiaries ^ Line 472: Less: Amounts claimed under subsections 104(13.1) and (13.2) (attach a statement) ^ \\ Line 47: Total deductible income allocations (line 471 minus line 472) = ^ Line 48: Income after allocations (line 46 minus line 47) = ^ \\ Line 49: Total gross-up amount of dividends retained or not designated by the trust (line 32 of Schedule 8) ^ \\ Line 50: Line 48 plus line 49. This is the trust's net income. = ^ Step 4 - Calculating taxable income (see lines 51 to 56 in the guide) Deductions to arrive at taxable income Line 51: Non-capital losses of other years (see line 51 in the guide) ^ Line 52: Net capital losses of other years (see line 52 in the guide) ^ Line 53: Capital gains deduction for resident spousal or common-law partner trust only (line 10 of Schedule 5) ^ Line 54: Other deductions to arrive at taxable income (specify - see line 54 in the guide) ^ Line 55: Add lines 51 to 54 = ^ \\ Line 56: Line 50 minus line 55. This is the trust's taxable income. = ^ If the amount is more than zero, enter the amount on line 56, and on line 1 of Schedule 11. If the amount is zero or negative, enter "0" on line 56. If minimum tax applies, enter the positive or negative result from line 56 on line 23 of Schedule 12. T3 RET (11) (Page 4 of 4) Step 5 - Summary of tax and credits (see lines 81 to 100 in the guide) Tax: \\ Line 81: Total federal tax payable (see line 81 in the guide) ^ \\ Line 82: Provincial or territorial tax payable (from the applicable provincial or territorial form) ^ Line 83: Part XII.2 tax payable (line 12 of Schedule 10) ^ Line 84: Add lines 81 to 83. Total taxes payable = ^ Credits: \\ Line 85: Tax paid by instalments ^ \\ Line C: Total tax deducted (see lines C, D, and 86 in the guide) ^ Line D: Transfer to Quebec ^ Line 86: Net tax deducted (line C minus line D) = ^ Line 87: Refundable Quebec abatement (line 45 of Schedule 11, or line 56 of Schedule 12) ^ Line 88: Refundable investment tax credit [Form T2038(IND)] ^ Line 89: Capital gains refund (Form T184) ^ Line 90: Part XII.2 tax credit (box 38 of T3 slip) ^ Line 91: Other credits (specify) ^ \\ Line 93: Add lines 85 to 91. Total credits = ^ \\ Line 94: Line 84 minus line 93. Refund or balance owing = ^ If the result is negative, you have a refund. If the result is positive, you have a balance owing. Generally, we do not refund or charge a difference of $2 or less. \\ Line 95: Amount enclosed ^ Payment: Attach a cheque or money order payable to the Receiver General. Do not mail cash. \\ Line 100: Refund code (see the guide for details) ^ \\ Name and address of person or company (other than trustee, executor, liquidator, or administrator) who prepared this return. ^ Postal code ^ Telephone number (including area code) ^ Certification (by trustee, executor, liquidator, or administrator) I,(please print) ^ certify that the information given on this return and in any documents attached is, to the best of my knowledge, correct, complete, and fully discloses the income from all sources. Authorized person's signature ^ Position or title ^ Date (Year/Month/Day) ^ Reporting foreign income and property If the trust is resident in Canada, you have to report its income from all sources, both inside and outside Canada. If the trust dealt with a non-resident trust or corporation in the year, contact us at 1-800-959-8281 for more filing requirements. Did the trust hold foreign property at any time in the tax year with a total cost of more than CAN$100,000? No or Yes ^ If yes, you may have to complete and attach Form T1135, Foreign Income Verification Statement. For filing requirements, see that form. Privacy Act, Personal Information Bank number CRA PPU 015