,transcrib]'s note3
  7,front page7

,canada ,rev5ue ,ag5cy

                           ,,cpt#a 7#jf7

      ,reque/ =a ,rul+ z 6! ,/atus
      (a ,"w] ,"u ! ,canada ,p5.n
     ,plan &/or ! ,employ;t ,9sur.e
                  ,act
    
  ,if y >e an employ] apply+ =a refund (
,,cpp 3tribu;ns or ;,,ei premiums pl1se
mail a -plet$ =m ;,,pd#bd 6yr regional
tax c5tre4
  ,,cra does n issue a rul+ = hypo!tical
or propos$ employ;t situ,ns4 ,if y >e
hav+ di6iculty 9 det]m9+ :e!r a "w] is
an employee or a self-employ$ 9dividual1
pl1se ref] 6public,n ,,rc#daaj4
  ,a "w]1 a pay] or an au?oriz$
repres5tative c use ? =m 6reque/ a rul+
z 6:e!r a "w]'s employ;t is p5.na# &/or
9sura#4                               #a
            ,reque/ =a rul+
  ,"u ! ,canada ,p5.n ,plan &! ,employ;t
,9sur.e ,act1 y c reque/ a rul+ 2f ,june
?irtie? (! ye> foll[+ ! ye> 6: ! "q
relates4
  ,once ? reque/ has be5 review$1 a
,,cpp/;,,ei ,(fic] w 3tact ! "w] &!
pay]1 ei 0teleph"o &/or 9 p]son1 6obta9
a4i;nal 9=m,n4
  ,? 9=m,n is obta9$ "u ! au?or;y (!
,canada ,p5.n ,plan &! ,employ;t ,9sur.e
,act4 ,! 3fid5tial;y (! 9=m,n is
protect$ 9 a3ord.e )! ,9come ,tax ,act1
,privacy ,act &! ,a3ess 6,9=m,n ,act4
  ,if ! rul+ reque/ 9volves m ?an "o
"w]3
    --,a li/ (! "ns1 "w & home teleph"o
      numb]s1 a4resses & social 9sur.e
      numb]s ( all 3c]n$ "w]s %d 2
      atta*$ 6! reque/4
  ,if "! >e multiple types ( employ;t3
    --,a li/ (! "ns1 "w & home teleph"o
      numb]s1 a4resses & social 9sur.e
      numb]s ( all 3c]n$ "w]s %d 2
                                      #b
            ,reque/ =a rul+
      atta*$ 6! reque/ = ea* type (
      employ;t4
  ,once a deci.n lr is issu$1 bo? ! pay]
&! "w]7s7 w 2 provid$ )! "r 6app1l \r
deci.n4
  ,"o -plet$ copy ( ? =m1 al;g ) any
relevant docu;ts1 s* z copies ( 3tracts1
agree;ts1 reports1 r\t+ %eets1 rules1
regul,ns1 etc41 %d 2 =w>d$ 6! ,,cpp/-
;,,ei ,eligibil;y ,divi.n ( yr tax
s]vices (fice4
  ,! a4ress ( yr tax s]vices (fice is
li/$ on \r ,web site at
_+www.cra.gc.ca/tso_: & 9 ! gov]n;t
sec;n ( yr teleph"o book4

,transcrib]'s note3
  7,back page7

  ,pl1se -plete all sec;ns 6! be/ ( yr
abil;y4


                                      #c
       ,:o is -plet+ ? applic,n8
    
,"w] ----
,pay] ----
,repres5tative ----

  7,9dicate :e!r y >e repres5t+ ! "w] or
! pay] & atta* yr cli5t's 3s5t =m
7,t#ajac7 or a lr t au?orizes ! ,,cra
64cuss 3fid5tial issues ) y47

                ,! ,pay]
    
,"n ( ,corporate ,5t;y1 ,op]at+ ,"n or
  ,"pn]%ip ,"n ----
,"n ( ,proprietor1 ,"pn] or ,corporate
  ,(fic] 7if applica#7 ----
,a4ress ----
,nature ( ,busi;s ----
,,cra ,busi;s ,numb] 7applica#1 if "kn7
  ----,,rp----
,teleph"o ,numb] 7----7 ----
,prov9ce 9 : ! "w 0 p]=m$ ----

                                      #d
                ,! ,"w]
    
,sur"n ( ,"w] ----
,a4ress ----
,social ,9sur.e ,numb] ----
,usual f/ "n & 9itials ----
,teleph"o ,numb]
  ,home 7----7 ----
  ,"w 7----7 ----
,"w]'s ,job ,title/,posi;n ----
,date on : employ;t />t$
  7,ye>/,mon?/,"d7 ----
,date on : employ;t t]m9at$ 7if
  applica#7 7,ye>/,mon?/,"d7 ----

  ,i "hby c]tify t1 6! be/ ( my k1 !
9=m,n 3ta9$ 9 ? reque/ & 9 ! atta*$
docu;ts is a3urate & -plete4

,date 7,ye>/,mon?/,"d7 ----
,pl1se pr9t yr "n & title 7if applica#7
  ----
,signature ----

                                      #e