I*Canada Revenue Agence du revenu T5 Statement of Investment Income Year 2019 Protected B / Protege B Etat des revenus de placement Dividends from Canadian corporations - Dividentes de societies canadiannes Federal credit - Credit for Annee when completed / une fois rempli 24 Actual an curt of engage dicerds 5Taxable arourt of eligble audenas Onvitiend tax credit for cigbie 13 Interest from Canadian sources 18 Capital gains dividends Montant reef ces civicendes aftermine Montart imposatie gos andindes 750.00 Credit al roitpour dividendes oftenines Actual amount of dividends Tarable amount of dividenigh Dividend tax credit for dividends Intorots do source canadianno Dividendos cur gains on capital 10 er thaneligible divid 11 offer than clique dividends 12 oferthan eligble dividends 21 Report Code 22 Recipient identification number 23 Recipient type 0 805 127 115 Montart moodbe dee capehart autres que ces civitenses after Code du fouillot Other information (see the back) Aures renseignements (liser lo verso) Box /Cas Amount / Montan Box /Case mount / Mortant Box / Cas Amount / Montent Recipient's name (last name first) and address - Nora, prenom et adresse du beneficiaire Payer's name and address - Nom of adresse du payour Dox Keith & Katie RBC Royal Bank 18 Page Place Your City, YP, L3A 2N7 Currency and identification codes Codes de devise et d'identification 27 20 29 For information, see the back. Transt - Succursale Recipient account Pour obtenir des renseignements, are the privacy notice on your Numero de comple du beneficiare T5 (19) um./ Consulte: I'svisde confidentialite dans votre declaration. lisez le verso. Canada Revenue Agence du revenu Year Agency du Canada T5 Statement of Investment Income Etat des revenus de placement 2019 Protected B / Protege B Dividends from Canadian corporations - Civicentes de societies canadiannes Federal credit - Credit federal Annee when completed / une fois rempli 24 Actual an curt of engine divoends 25 Taxcle arout of efgble avaends 26 Orvitend tax credit for eiga 13 Interest from Canadian sources 18 Capital gains dividends Montant reel des dividendes afterrings mpotatie dis avidinars otternines 10 Actus amount of dudends 11 Tarabie input of dividends Credit al roit pour dividendes ationines other than eligible dividends 12 Ofridend tax credit for dividends Intorots do source canadianno Dividendos cur gains on capital offer than eligble Guilends 21 Report Code 22 Recipient identification number 23 Recipient type 0 805 127 115 acres que des dividinges oftors ines ites que ces crusenses oftenrings Code du fouillet Nunice didentification dy benthoare Other information (see the back) Aures renseignements 17 875.00 "(his er le verso) Box /Case Amount / Mortant Box /Case Amount / Mortant Box /Case Amount / Monitent Recipient's name (last name first) and address - Nor, prenom at adress du beneficiaing Payer's name and address -Nom of adrosso dupayour Dox Keith Cut You! 18 Page Place Your City, YP, L3A 2N7 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, See the privacy notice on your return./ Consulter I'svisde confidentinite dans votre declaration, Numero de comple du beneficiare lisez le verso. T5 (19) Use the fillable forms package available for download from uLearn > Connect > All communities > Tax Academy 2020 > Topics > English > Fundamentals of Income Tax (Level 1) > Fillable Forms Packages