*** 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. *** Manitoba TD1MB E (12) (Front) 2012 MANITOBA PERSONAL TAX CREDITS RETURN Your employer or payer will use this form to determine the amount of your provincial tax deductions. Read the back before completing this form. Complete this form based on the best estimate of your circumstances. Last name ^ First name and initial(s) ^ Date of birth (Year/Month/Day) ^ Employee number ^ Address including postal code ^ For non-residents only - Country of permanent residence ^ Social insurance number (enter 9-digit number) ^ 1. Basic personal amount - Every person employed in Manitoba and every pensioner residing in Manitoba can claim this amount. If you will have more than one employer or payer at the same time in 2012, see "Will you have more than one employer or payer at the same time?" on the next page. 8,634 2. Age amount - If you will be 65 or older on December 31, 2012, and your net income from all sources will be $27,749, or less, enter $3,728. If your net income for the year will be between $27,749 and $52,602 and you want to calculate a partial claim, get the TD1MB-WS, Worksheet for the 2012 Manitoba Personal Tax Credits Return, and complete the appropriate section. ^ 3. Pension income amount - If you will receive regular pension payments from a pension plan or fund (excluding Canada Pension Plan, Quebec Pension Plan, Old Age Security, or Guaranteed Income Supplement payments), enter $1,000, or your estimated annual pension income, whichever is less. ^ 4. Tuition and education amounts (full time and part time) - If you are a student enrolled at a university, college, or educational institution certified by Human Resources and Skills Development Canada, and you will pay more than $100 per institution in tuition fees, complete this section. If you are enrolled full time, or if you have a mental or physical disability and are enrolled part time, enter the total of the tuition fees you will pay, plus $400 for each month that you will be enrolled. If you are enrolled part time and do not have a mental or physical disability, enter the total of the tuition fees you will pay, plus $120 for each month that you will be enrolled part time. ^ 5. Disability amount - If you will claim the disability amount on your income tax return by using Form T2201, Disability Tax Credit Certificate, enter $6,180. ^ 6. Spouse or common-law partner amount - If you are supporting your spouse or common-law partner who lives with you, and whose net income for the year will be less than $8,634, enter the difference between $8,634 and his or her estimated net income. If your spouse's or common-law partner's net income for the year will be $8,634 or more, you cannot claim this amount. ^ 7. Amount for an eligible dependant - If you do not have a spouse or common- law partner and you support a dependent relative who lives with you, and whose net income for the year will be less than $8,634, enter the difference between $8,634 and his or her estimated net income. If your eligible dependant's net income for the year will be $8,634 or more, you cannot claim this amount. ^ 8. Caregiver amount - If you are taking care of a dependant who lives with you, whose net income for the year will be $12,312 or less, and who is either your or your spouse's or common-law partner's: - parent or grandparent (aged 65 or older); or - relative (aged 18 or older) who is dependent on you because of an infirmity, enter $3,605. If the dependant's net income for the year will be between $12,312 and $15,917 and you want to calculate a partial claim, get the TD1MB-WS, and complete the appropriate section. ^ 9. Amount for infirm dependants age 18 or older - If you are supporting an infirm dependant aged 18 or older who is your or your spouse's or common-law partner's relative, who lives in Canada, and whose net income for the year will be $5,115 or less, enter $3,605. You cannot claim an amount for a dependant you claimed on line 8. If the dependant's net income for the year will be between $5,115 and $8,720 and you want to calculate a partial claim, get the TD1MB-WS, and complete the appropriate section. ^ 10. Amounts transferred from your spouse or common-law partner - If your spouse or common-law partner will not use all of his or her age amount, pension income amount, tuition and education amounts, or disability amount on his or her income tax return, enter the unused amount. ^ 11. Amounts transferred from a dependant - If your dependant will not use all of his or her disability amount on his or her income tax return, enter the unused amount. If your or your spouse's or common-law partner's dependent child or grandchild will not use all of his or her tuition and education amounts on his or her income tax return, enter the unused amount. ^ 12. Manitoba Family Tax Benefit - Get the TD1MB-WS and complete the appropriate section. ^ 13. TOTAL CLAIM AMOUNT - Add lines 1 through 12. ^ Your employer or payer will use your claim amount to determine the amount of your provincial tax deductions. Continue on the next page TD1MB E (12) (Back) Completing Form TD1MB Complete this form only if you are an employee working in Manitoba or a pensioner residing in Manitoba and any of the following apply: - you have a new employer or payer and you will receive salary, wages, commissions, pensions, Employment Insurance benefits, or any other remuneration; - you want to change amounts you previously claimed (such as when the number of your eligible dependants has changed); - you want to increase the amount of tax deducted at source. Sign and date it and give it to your employer or payer. If you do not complete a TD1MB form, your new employer or payer will deduct taxes after allowing the basic personal amount only. Will you have more than one employer or payer at the same time? If you have more than one employer or payer at the same time and you have already claimed personal tax credit amounts on another Form TD1MB for 2012, you cannot claim them again. If your total income from all sources will be more than the personal tax credits you claimed on another Form TD1MB, enter "0" on line 13 on the front page and do not complete lines 2 to 12. Total income less than total claim amount Check this box (enter x) if your total income for the year from all employers and payers will be less than your total claim amount on line 13. Then your employer or payer will not deduct tax from your earnings. ^ Additional tax to be deducted If you wish to have more tax deducted, complete the section called "Additional tax to be deducted" on the federal Form TD1. Reduction in tax deductions You can ask to have less tax deducted if on your income tax return you are eligible for deductions or non-refundable tax credits that are not listed on this form (for example, periodic contributions to a Registered Retirement Savings Plan (RRSP), child care or employment expenses, and charitable donations). To make this request, complete Form T1213, Request to Reduce Tax Deductions at Source for year(s) XXXX, to get a letter of authority from your tax services office. Give the letter of authority to your employer or payer. You do not need a letter of authority if your employer deducts RRSP contributions from your salary. Forms and publications To get forms and publications go to www.cra.gc.ca/forms or call 1-800-959- 2221. Certification I certify that the information given in this return is, to the best of my knowledge, correct and complete. Signature ^ It is a serious offence to make a false return. Date (Year/Month/Day) ^