Transcriber's Note: Please set your voice synthesizer to read most 
punctuation. When you encounter the caret sign, please enter the applicable 
information, if necessary. *** 
 
T1036 (05) 
 
Canada Customs and Revenue Agency 
 
HOME BUYERS' PLAN (HBP) REQUEST TO WITHDRAW FUNDS FROM AN RRSP 
 
Use this form to make a withdrawal from your registered retirement savings 
plan (RRSP) under the Home Buyers' Plan (HBP). Answer the questions in Part A 
of Area 1 to determine if you are eligible to make a withdrawal from your RRSP 
under the HBP. Although some conditions may apply to another person in certain 
situations, you (the participant) are responsible for making sure that all the 
conditions are met. For more details about the HBP, read the guide RC4135, 
Home Buyers' Plan (HBP). 
 
Area 1 - Participant 
 
Part A - Complete the following questionnaire to determine if you can make a 
withdrawal from your RRSP under the HBP 
 
*** Transcriber's note: For questions 1 to 6, enter an "X" to the applicable 
answer. *** 
 
1. Are you a resident of Canada? 
Yes go to question 2. ^
No you cannot make an HBP withdrawal ^
 
2. Has the person who is buying or building a qualifying home entered into a 
written agreement to do so? 
Yes go to question 3(a). ^
No you cannot make an HBP withdrawal. ^
 
3(a). Have you ever, before this year, withdrawn funds from your RRSP under 
the HBP to buy or build a qualifying home? 
Yes go to question 3(b). ^
No go to question 4(a). ^
 
3(b). Are you making this withdrawal in January as part of the participation 
you began last year? 
Yes go to question 4(a). ^
No go to question 3(c). ^
 
3(c). Was your HBP balance zero on January 1 of this year? 
Yes go to question 4(a). ^
No you cannot make an HBP withdrawal. ^
 
4(a). Are you a disabled person? 
Yes go to question 5. ^
No go to question 4(b). ^
 
4(b). Are you withdrawing funds from your RRSP to buy or build a qualifying 
home for a related disabled person or to help such a person to buy or build a 
qualifying home? 
Yes go to question 5. ^
No go to question 4(c). ^
 
4(c). Are you considered a first-time home buyer? 
Yes go to question 5. ^
No you cannot make an HBP withdrawal. ^
 
5. Does the person who is buying or building a qualifying home intend to 
occupy it as his or her principal place of residence no later than one year 
after buying or building it? If you are acquiring the home for a related 
disabled person or helping a related disabled person acquire the home, you 
must intend that the related disabled person occupy the home as his or her 
principal place of residence. 
Yes go to question 6. ^
No you cannot make an HBP withdrawal. ^
 
6. Has the person who is buying or building the qualifying home or his or her 
spouse or common-law partner owned the home more than 30 days before receiving 
this withdrawal? 
Yes you cannot make an HBP withdrawal. ^
No you are eligible (complete Part B). ^
 
Part B - Complete this part to make a withdrawal from your RRSP under the HBP 
 
First name and initials ^
Last name ^
Social insurance number (SIN) ^
Address of qualifying home being bought or built (include number, street, 
rural route, or lot and concession number) ^
City ^
Province ^
Postal code ^
Telephone number (including area code) ^
If you are a disabled person, please enter "X". ^
 
If you answered "Yes" to question 4(b) above, provide the following 
information about that person: 
Person's name ^
Relationship to you ^
Disabled person's SIN ^
 
Certification 
 
Amount of requested withdrawal $ ^
Date of request Year/Month/Day ^
 
I certify that the information given in Area 1 of this form is correct. 
Participant's signature ^
 
Area 2 - RRSP issuer (Do not send to CCRA - Keep for your records) 
 
Issuer's name ^
Issuer's address ^
Name and position of person to contact for more information ^
Telephone number (including area code) ^
 
Amount paid (maximum $20,000) $ ^
Plan number of the RRSP from which the withdrawal is made ^
Date of withdrawal Year/Month/Day ^
 
If the participant or the participant's spouse or common-law partner 
contributed to this RRSP during the 89-day period just before the withdrawal, 
 
Name of contributor ^
Date of contribution Year/Month/Day ^
 
Amount of contribution $ ^
Fair market value of the funds held in this RRSP immediately after the 
withdrawal. $ ^