Clear Data Payer's name - Nom du payour Canada Revenue Agence du revenu Agency du Canada T4A CAF REGISTERED PENSION PLAN Statement of Pension, Retirement, Annuity. 101 COLONEL BY DRIVE Year 2019 OTTAWA, ONTARIO Annee and Other Income Etat du revenude pension, de retraite, de rente K1A 0K2 ou d'autres source Pension or superannuateon - line 11500 Prestations de retraite ou autres Income tax deducted - line 43700 061 Payer's account number / Numero de comple du payeur pensions - ligne 11500 Impot sur le revenue retenu = ligne 43700 XXXXXXXXXXXXXXX 016 70,000.00 02 10,000 00 Social insurance number Recipient's account number Numero d'assurance sociale Numero de compte du beneficialre Lump sum payments - line 13000 Self-employed commissions 012 013 Paiements forfaltaires - ligne 13000 Commissions d'un travel independant 627000145 016 020 T4A (19) Protected B when completed / Protege B une fois rempli Fees for services Recipient's name and address - Nom et adresse du beneficiaire Annuities Honoraires ou autres sommes First name - Prenom Initials- hisales Rentes pour services rendus Last name (print) - Nom de famille ten lettres mouldes DOODE JAMES 024 048 Other information (see page 2) 123 MAIN STREET Autres renseignements (voir a la page 2) ANYTOWN, ONTARIO KOH 1H0 Box - Cas Amount - Montant Box - Case Amount - Montant Box - Cas Amount - Montant Box Case Amount - Montant Box - Case Amount - Montant Box - Case Amount - Montent Box - CAS Amount - Montant Box - Case Amount - Montant Box - Case Amount - Montant Box - Case Amount - Montent Box - Case Amount - Montant Box - Case Amount - Montant Canada Revenue Agence du revenuClear Data Employer's name - Nom de femployeur Canada Revenue Agence du revenu T4 JAMES' SPECIALTY BIKE SHOP Agency du Canada 124 MAIN STREET Year Statement of Remuneration Paid ANYTOWN, ONTARIO Annee 2019 Etat de la remuneration payee KOH 1HO Employment Income - line 101 Revenus d'empiol - ligne 101 Income tax deducted - line 437 mpot sur le revenue retonu - ligne 437 14 18,000.00 22 4,000.00 Protected B when completed / Protege B une fois rempli 54 Employer's account number / Numero de compte de femployour Province of employment Employee's CPP contributions - line 308 El Insurable earnings XXXXXXXXXXXXXxx Province d'emploi Cotisations de l'employe au RPC - Igne 309 Gains assurables d'AE Social insurance number 10 ON 16 24 Exempt - Exemption 739.50 18,000.00 Numero d'assurance sociale CPP/OPP FI PPIP Employment code Employee's OPP contributions - line 306 12 30692544 28 HOH CPP/OPP pensionable eamings Code d'emploi Cotisations de l'employs au RRO - ligne 308 Gains ouvrant droit a pension - RPC/RRQ 29 17 26 RPC/RRQ AE RPA 18,000.00 Employee's El premiums - line 312 Cotisations de l'employe & MAE - ligne 312 Union dues - line 212 Employee's name and address - Nom et adresse de l'employe Cotisations syndicales - ligne 212 Last name (in capital letters) - Nom de famille fon lettres mould First name -Prinom 18 291.60 44 BOND SUSAN RPP contributions - line 207 Colisations a un RPA - ligne 207 Charitable donations - line 349 ons de bienfaisance - ligne 349 20 46 123 MAIN STREET Pension adjustment - line 206 RPP or DPSP registration number ANYTOWN. ONTARIO acteur d'equivalence - ligne 206 N' d'agrement d'un RPA ou d'un RPDB KOH 1HO 52 50 Employee's PPIP premiums - see over PPIP insurable eamings Cotisations de l'employs au RPAP - voir au verso Gains assurables du RPAP 55 56 Box - Case Amount - Montant Box - Case Amount - Montant Box - Case Amount - Montant Other information (see over) T4 (18) Autres Box - Cape Amount - Montant Box - Case Amount - Mantant Box - Case Amount - Montant renseignements (voir au verso)Clear Data Canada Revenue Agency Agence du revenu du Canada T5 Statement of Investment Income Year 2019 Protected B / Protege B Etat des revenus de placement when completed / une fois rempli Dividends from Canad n corporations - Dividendes de so Federal credit - Credit federal Annee 24 Actual amount of eligible divide 25 | Taxable amount of eligible dividends 26 Dividend tax credit for eligible dividends Interest from Canadian sources | 18 Capital gains dividends 12,000.00 16.560.00 2,487.27 Montant reel dos dividendes determines Montant imposable des dividendes determines Credit dimpot pour dividendes determines Interits de source canadianno Dividendes sur gains on capital 10 Actual amount of dividends other than eligible dividends axable amount of dividends other than eligible dividends 12 Dividend tax credit for dividend other than eligible dividends 21 Report Code 22 | Recipient identification number 23 Recipient type O 527000145 Montand real des dividendes autres que dos dividendes determinds Montant imposable des dividendes utes que des dividendes determine Credit dimpot pour dividendes ones que des dividendes determing Code du feuillet Numero d identification du benefic aire Type de bandficiaire Other Information (see the back) Autres renseignements (lisez le verso) Box / Case Amount / Montant Box / Case Amount / Montant Box / Case Amount / Montant Recipient's name (last name first) and address - Nom, prenom at adresse du beneficiairo Payer's name and address - Nom et adresse du payeur JAMES DOODE GREAT BANK OF CANADA 123 MAIN STREET 456 BAY STREET ANYTOWN, ONTARIO TORONTO ONTARIO KOH 1HO M5J 2J5 Currency and Identification codes Codes de devise et d'identification 27 28 29 For information, see the back. Foreign currency Transit - Succursale Recipient account Pour obtenir des renseignements, Devises strangeres See the privacy notice on your retum/ Consultez l'avis de confidentialite dans votre declaration empte du beneficiaire lisez le verso.Clear Data Canada Revenue Agence du revenu Statement of Investment Income Year Protected B / Protege B Agency du Canada T5 Etat des revenus de placement 2019 when completed / une fois rempli Dividends from Canadian corporations - Dividendes de societies canadiennes Federal credit - Credit federal Annee 24 Actual amount of eligible dividends |Taxable amount of eligible dividends 26 Dividend tax credit for eligible dividends Interest from Canadian sources Capital gains dividends 7,000.00 Vontant reel des dividendes determines Montant imposable des dividendes determines Credit dimpot pour dividendes determines Interets de source canadienne Dividendes sur gains on capital 10 other than eligible dividends e amount of d other than eligible dividends 12 other than 21 Report Code 22 | Recipient identification number 23| Recipient type O 627000145 2 Montant noel des dividendos Montant imposable des dividendes autres que des dividendes determinds Credit d'impot pour dividendes uves que des dividendes determines utes que des dividendes determing Cade du feuillet Numero d identification du benificlaire Type de bandficinina Other Information (see the back) Autres renseignements (lisez le verso) Box / Case Amount / Montant Box / Case Amount / Montant Box / Case Amount / Montan Recipient's name (last name first) and address - Nom, prenom at adresse du beneficiaire Payer's name and address - Nom et adresse du payeur JAMES DOODE (50%) AND SUSAN BOND (50%) ANYTOWN BANK OF CANADA 123 MAIN STREET 456 MAIN STREET ANYTOWN, ONTARIO ANYTOWN ONTARIO KOH 1HO KOH 1H0 Currency and identification codes Codes de devise et d'identification 27 28 29 For information, see the back. Foreign currency Transit - Succursale Recipient account Pour obtenir des renseignements, Devises strangeres Numero de compte du beneficiaire lisez le verso. See the privacy notice on your retum / Consultez l'avis de confidentialite dans votre declaration T5 (171Clear Data Agence du revenu Year VOID Anne ANNULE 10 Report code 11 Protected B / Protege B Code du feuillet Recipient type Type de beneficiaire 12 Recipient identification number Numero d'identification du beneficialre 13 Foreign currency du Canada Devises etrangeres when completed / une fois rempli 2019 O 1 527-000-145 T5008 Statement of Securities Tearsactions Itat des oofcallers sur flies 14 Date 15 Type code of securities 16 Quantity of securities Quantite de titres 17 Identification of securities MMDD - MMJJ Code de genre de titres Designation des titres Canada Revenue 12-01 SHS 1,500 SHARES OF GREAT BANK OF CANADA 18 ISIN/CUSIP number Face amount Cost or book value Proceeds of disposition or settlement amount Numero ISINICUSIF valeur nominale Cout ou valour comptable Produits de disposition ou palements Agency 42,000.00 7,500.00 22 Type code of securities received on settlement Code de genre de titres recus on guise de 23 Quantity of securities received on settlement 24 | Identification of securities received on settlement Quanthe de titres recus on guise de reglemen Designation des titres recus en guise de reglement reglement Nom de famile (en lettres mouldes] First name and initials - Prenom of initiales Jame and address of trader or dealer in securities DOODE, JAMES Jom et adresse du negociant ou du courtier en valeurs Beneficiaire 123 MAIN STREET ABC SECURITIES BROKER Recipient ANYTOWN ON KOH 1HO 1000 MAIN STREET ANYTOWN ON KOH 1HO See the privacy notice on your notum. Consultez ravis de confidentialind dans votre declaration. T5008 (19)Clear Data Canada Revenue Agency Agence du revenu du Canada Tuition and Enrolment Certificate Protected B when completed For student 1 . Issue this certificate to a student who was enrolled during the calendar year in a qualifying educational program or a specified educational program at a post-secondary institution, such as a college or university, or at an institution certified by Employment and Social Development Canada (ESDC) Tuition fees paid in respect of the calendar year to any one institution have to be more than $100. Fees paid to an institution certified by ESDC or to a post-secondary educational institution in Canada for courses that are not at a post-secondary school level, have to be for courses taken to get or improve skills in an occupation, and the student has to be 16 years of age or older before the end of the year. Students calculate their provincial or territorial education amounts (if applicable) based on the number of months indicated in Box B or C below. Name of program or course Student number SPECIALISED MECHANICS 123456789 Name and address of student JAMES DOODE Session periods, part-time and full-time Eligible tuition fees, s, Number of months for: 123 MAIN STREET part-time and ANYTOWN, ONTARIO From To full-time sessions B KOH 1HO Y M Part-time Full-time 2019 01 201904 5.000.00 04 2019 09 201912 5,000.00 04 Totals 10,000.00 08 Name and address of educational institution ANYTOWN LOCAL COLLEGE Information for students: See the back of slip 1. If you want to transfer all or part of your tuition amount, complete the back of slip 2. T2202A E (18)