*** 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. *** STATEMENT OF RRSP INCOME T4RSP (11) (Front) Year ^ Box 16: Annuity payments ^ Box 18: Refund of premiums ^ Box 20: Refund of excess contributions ^ Box 22: Withdrawal and commutation payments^ Box 25: LLP withdrawal ^ Box 26: Amounts deemed received on deregistration^ Box 28: Other income or deductions ^ Box 30: Income tax deducted ^ Box 34: Amounts deemed received on death ^ Box 27: HBP withdrawal ^ Box 35: Transfers on breakdown of marriage or common-law partnership^ Recipient's name and address ^ Last name (print) ^ First name ^ Initials ^ Box 24: Contributor spouse or common-law partner Yes or No ^ Box 36: Spouse's or common-law partner's Social insurance number* (enter 9- digit number) ^ Box 12: Social insurance number* (enter 9-digit number) ^ Box 14: Contract number ^ Box 60: Name of payer (issuer) of plan ^ Box 61: Account number ^ Box 40: Tax-paid amount ^ *If your social insurance number is not shown, see the back of this slip. T4RSP (11) (Back) HOW TO COMPLETE THIS SLIP Complete this form using the instructions in Guide T4079, T4RSP and T4RIF Guide. If you file your T4RSP slips online you may choose one of the following electronic filing formats: 1) Internet File Transfer (XML) 2) Web Forms For more information about filing electronically, go to www.cra.gc.ca/iref. You can also file your T4RSP slips online at: - www.cra.gc.ca/representatives, for authorized representatives; or - www.cra.gc.ca/mybusinessaccount, for business owners. If you file your T4RSP slips on paper: - Use one sheet for three different beneficiaries for the copy you are sending to the CRA. Do not separate the slips when you send them with your T4RSP Summary. - Use a separate sheet for the two copies you are giving to the beneficiary and the copy you are keeping in your records. Do not print your Account Number (box 61) on the copies you give to the beneficiary. Keep a copy of this slip for your records and attach the other copy to your tax return. For information on how to report your income, see your Income Tax and Benefit Guide. Under the Income Tax Act, you have to give your social insurance number (SIN) on request to any person who prepares an information slip for you. If you do not have a SIN, you can apply for one through any Service Canada Centre. - Box 16 – This is the total amount of annuity payments received in the year. Enter it on line 129 of your return. - Box 18 – This is the amount paid to the spouse or common-law partner because of the annuitant's death. Enter it on line 129 of your return. However, if the amount was rolled over from a deceased annuitant's RRSP to a registered disability savings plan, enter this amount on line 129 and line 232 of the deceased's return. Form RC4625, Rollover to a Registered Disability Savings Plan (RDSP) Under Paragraph 60(m), must be attached to the deceased's return. If you are an eligible individual, enter the amount of the rollover on line 130 and the amount transferred on line 232 of your return. For more information, see Information Sheet RC4177, Death of an RRSP Annuitant. - Box 20 – This is the amount refunded because it was not deducted from income. Enter it on line 129 of your return. Include a copy of the approved Form T3012A, Tax Deduction Waiver on the Refund of Your Unused RRSP Contributions Made in XXXX. You can deduct an offsetting amount on line 232 for the amount shown in this box. - Box 22 – This is the amount withdrawn from an RRSP in the year, or the amount paid as full or partial commutation of an RRSP annuity. Enter it on line 129 of your return. If the amount withdrawn was not deducted from income as an RRSP contribution, you may be able to claim an offsetting amount on line 232. For more information, see line 232 of The General Income Tax and Benefit Guide and Form T746, Calculating Your Deduction for Refund of Unused RRSP Contributions. - Boxes 24 and 36 – If yes is ticked in box 24, or the SIN of the spouse or common-law partner who made the contributions is shown in box 36, the contributor spouse or common-law partner may have to include in income part or all of the amounts in boxes 20, 22, or 26. For more information, see Form T2205, Amounts From a Spousal or Common-Law Partner RRSP or RRIF to Include in Income for XXXX. - Box 25 – This is the amount withdrawn from an RRSP under the Lifelong Learning Plan (LLP). This amount is not included in income, but you have to enter it on line 17 of Schedule 7. - Box 26 – This is the fair market value of all the property held by the RRSP just before it became an amended plan. Enter it on line 129 of your return. - Box 27 – This is the amount withdrawn from an RRSP under the Home Buyer's Plan (HBP). This amount is not included in income, but you have to enter it on line 15 of Schedule 7. - Box 28 – Enter any income amounts on line 129 and any deductions (amount shown in brackets) on line 232 of your return. - Box 30 – Enter this amount on line 437 of your return. - Box 34 – This is the fair market value of all the property held by the RRSP at the time of the annuitant's death. For information on how to report this amount, see Guide T4040, RRSPs and Other Registered Plans for Retirement. - Box 35 – This is the amount directly transferred on breakdown of a marriage or common-law partnership. This amount is not included in income. - Box 40 – This amount is used to calculate the amount that has to be reported on the final return of the deceased annuitant. For more information, see Guide T4040, RRSPs and Other Registered Plans for Retirement. Privacy Act, Personal Information Bank number CRA PPU 005