Tax Form 2022 – L.I.P.I

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Tax Form 2023

ACKNOWLEDGMENT AND CONSENT

1.Your income tax return will be completed by a volunteer registered with Canada Revenue Agency’s Community Volunteer Income Tax Program (CVITP) at Low Income People Involvement of Nipissing (LIPI).

2.It is your responsibility to ensure that all receipts, documents, and information provided is correct, truthful and complete. Any missing information will cause a delay in income tax completion

3.While our volunteers have received training to assist you in completing your income tax return, neither LIPI nor the volunteers can make any guarantee as to the accuracy or completeness of the returns. LIPI cannot represent you dealing with the Canada Revenue Agency (CRA) should your return be audited, nor be responsible for any penalties or additional tax assessed.

Unique ID

Consent(Required)

I hereby acknowledge that I have read and understood the above information.(Required)

Consent(Required)

I acknowledge that the process can up take four to six weeks.(Required)

Consent(Required)

I of the District of Nipissing, in the Province of Ontario, hereby give my permission and authorize you providing information to any representative of Low Income People Involvement of Nipissing.(Required)

Consent(Required)

I further consent to the release of information about my Case by any representative of the Low Income People Involvement of Nipissing to such persons as that representative considers necessary in order to represent me, subject to any express instructions from me.(Required)

Information of applicant

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Email(Required)

Canadian Citizen(Required)

Yes

No

Phone(Required)

SIN #(Required)

You must be a Canadian citizen to file taxes.

Partner / Spouse

Do you have a Partner/Spouse?(Required)

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Canadian Citizen(Required)

Yes

No

Phone(Required)

SIN #(Required)

Marital Status

Marital Status(Required)

Single

Common-Law

Married

Divorced

Separated

Widowed

Did your marital status changed in 2023?(Required)

Yes

No

Date of Marital Change(Required)

DD slash MM slash YYYY

Previous Marital Status(Required)

Single

Common-Law

Married

Divorced

Separated

Widowed

Address

Applicant Address(Required)

Apt no./House no. and Street name City Postal Code

Province (Ontario Only)

Benefits and Credits

Do you want Trillium Benefits starting

Monthly (July 2024)

Yearly (June 2025)

Does anyone in your family receive a Disability Tax Credit?(Required)

Who:(Required)

Dependents

Number of Dependents(Required)

Please enter a number from 0 to 12.

Dependent 1

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Dependent 2

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Dependent 3

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Dependent 4

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Dependent 5

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Dependent 6

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Dependent 7

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Dependent 8

Name 6(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Dependent 9

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Dependent 10

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Dependent 11

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Dependent 12

Name(Required)

First Last

Date of Birth(Required)

DD slash MM slash YYYY

Relationship(Required)

SIN #

Rent or Property Tax for 2023 (Ontario Only)

Have many residences have you lived in from Jan 1 2023 - Dec 31 2023?(Required)

Address 1(Required)

Apt no./House no. and Street name City

Province (Ontario Only)

Start Date 1(Required)

DD slash MM slash YYYY

End Date 1(Required)

DD slash MM slash YYYY

Name of Landlord or Municipality for Taxes(Required)

Address 2(Required)

Apt no./House no. and Street name City

Province (Ontario Only)

Start Date 2(Required)

DD slash MM slash YYYY

End Date 2(Required)

DD slash MM slash YYYY

Name of Landlord or Municipality for Taxes(Required)

Address 3(Required)

Apt no./House no. and Street name City

Province (Ontario Only)

Start Date 3(Required)

DD slash MM slash YYYY

End Date 3(Required)

DD slash MM slash YYYY

Name of Landlord or Municipality for Taxes(Required)

Address 4(Required)

Apt no./House no. and Street name City

Province (Ontario Only)

Start Date 4(Required)

DD slash MM slash YYYY

End Date 4(Required)

DD slash MM slash YYYY

Name of Landlord or Municipality for Taxes(Required)

Rent 2023

Total Rent paid 2023(Required)

Upload Files

Rent Or Property Taxes Receipts(Required)

Drop files here or

Max. file size: 15 MB.

Income Verification (T4 and T5´s)(Required)

Drop files here or

Max. file size: 15 MB.

Complete all the above information that applies to you. All 2023 income verification (T4/T5/ etc.) for you and any dependants (spouse, children, etc.) are required. Rent or Property Tax receipts would be preferred.

INCOME TAX RETURNS WILL NOT BE E-FILED UNTIL THEY ARE PICKED UP OR CONFIRMED. AFTER TWO WEEEKS OF NOTIFICATION ALL INFORMATION LEFT WILL BE SHREDDED

Δ

L.I.P.I

127 Main Street East, North Bay, ON , P1B1A9
Ontario, Canada

Phone: (705) 472-1337

Email: [email protected]

Office Opening Hours

Monday:

8:00am-4:00pm (Open to the public 10:00am-2:00pm)

Tuesday:

Closed

Wednesday:

8:00am-4:00pm (Open to the public 10:00am-2:00pm)

Thursday:

8:00am-4:00pm (Open to the public 10:00am-2:00pm)

Friday:

8:00am-4:00pm (Open to the public 10:00am-2:00pm)

Saturday:

Closed

Sunday:

Closed

© LIPI 2024