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T1044 E (05) (Front) 
 
Canada Customs and Revenue Agency 
 
NON-PROFIT ORGANIZATION (NPO) INFORMATION RETURN 
 
Do not use this area 
 
This return is for: 
 
- non-profit organizations (NPOs) described in paragraph 149(1)(l) of the 
Income Tax Act; and 
 
- organizations described in paragraph 149(1)(e) of the Act (agricultural 
organizations, boards of trade or chambers of commerce). 
 
An organization may have to file this return if: 
 
- it received or is entitled to receive taxable dividends, interest, rentals 
or royalties of more than $10,000 in the fiscal period; 
 
- it owned assets valued at more than $200,000 at the end of the immediately 
preceding fiscal period; or 
 
- it had to file a NPO return for a previous fiscal period. 
 
To determine if the organization you represent has to complete this return, 
please see the T4117, Income Tax Guide to the Non-Profit Organization (NPO) 
Information Return. 
 
Send your completed return to: Ottawa Technology Centre, 875 Heron Road, 
Ottawa ON K1A 1A2 
 
Section A - Identification 
 
Fiscal period 
From (Year/Month/Day) ^
to (Year/Month/Day) ^
 
Name of organization ^
Mailing address ^
City ^
Province ^
Postal code ^
 
Business Number (BN), if any (enter the first nine digits) ^
Trust (T-3) number, if any T (8 digits number) ^
 
Is this the final return to be filed by this organization? If yes, please 
attach an explanation. 1 Yes or 2 No ^
 
Type of organization (see the guide, T4117)) (2 digits number) ^
 
Name and title of person to contact ^
Area code ^
Telephone number ^
 
Section B - Amounts received during the fiscal period 
 
Line 100: Membership dues, fees, and assessments ^
Line 101: Federal, provincial, and/or municipal grants and payments ^
Line 102: Interest, taxable dividends, rentals, and royalties ^
Line 103: Proceeds of disposition of capital property ^
Line 104: Gross sales and revenues from organizational activities ^
Line 105: Gifts ^
Line 106: Other receipts (specify) ^
Line 107: Total receipts (add lines 100 to 106) ^
 
Section C - Statement of assets and liabilities at the end of the fiscal 
period 
 
Assets 
 
Method used to record assets ^
 
Line 108: Cash and short-term investments ^
Line 109: Amounts receivable from members ^
Line 110: Amounts receivable from all others (not included on line 109) ^
Line 111: Prepaid expenses ^
Line 112: Inventory ^
Line 113: Long-term investments ^
Line 114: Fixed assets ^
Line 115: Other assets (specify) ^
Line 116: Total assets (add lines 108 to 115) ^
 
Liabilities 
 
Line 117: Amounts owing to members ^
Line 118: Amounts owing to all others (specify) ^
Line 119: Total liabilities (add lines 117 and 118) ^
 
 
T1044 E (05) (Back) 
 
Section D - Remuneration 
 
Line 120: Total remuneration and benefits paid to all employees and officers ^
 
Line 121: Total remuneration and benefits paid to employees and officers who 
are members ^
 
Line 122: Other payments to members (specify) ^
 
Number of members in the organization ^
Number of members who received remuneration or other amounts ^
 
Section E - The organization's activities 
 
Briefly describe the activities of the organization. If this is the 
organization's first year filing this return, attach a copy of the 
organization's Mission Statement. ^
 
Are any of the organization's activities carried on outside of Canada? 1 Yes 
or 2 No ^
If yes, please indicate where: ^
 
Section F - Location of books and records 
 
Leave this area blank if the information is the same as that in Section A 
 
Name of person to contact ^
Mailing address ^
City ^
Province ^
Postal code ^
Area code ^
Telephone number ^
 
Section G - Certification 
 
To be signed only by a current officer of the organization. 
 
I, Name of officer whose signature appears below (print) ^
Of City and Province ^
 
certify that the information given on this return is, to the best of my 
knowledge, correct and complete. 
 
Authorized officer's signature ^
Position or office within the organization ^
 
Date (Year/Month/Day) ^
Language of correspondence 
Indicate the language of your choice 1 English or 2 French ^